A feasibility and dosimetric evaluation of endoscopic radiofrequency ablation for human colonic and rectal epithelium in a treat and resect trial.

Surgical Endoscopy
Joseph A TrunzoJeffrey M Marks

Abstract

Endoscopic radiofrequency ablation (RFA) has been used effectively for ablation of foregut disorders and also may have a role in treating colonic pathology. This study aimed to assess the feasibility of delivering RFA to locations within the colon and to determine a range of safe treatment parameters. Patients undergoing left hemicolectomy or proctocolectomy were evaluated. Focal RFA using a colonoscope-mounted device was delivered to normal segments of the colon and rectum within the planned surgical resection specimen. Endoscopic accessibility and feasibility of delivering heat energy to the colon and rectum were assessed as well as the maximum incurred histologic depth of ablation in relation to the number of applications (2 or 4) and the energy density (12, 15, or 20 J/cm2). A total of 51 ablation zones in 16 patients had available histopathology. None of the sites receiving two applications demonstrated serosal layer alteration compared with 15% of the sites receiving four applications (p=0.11). Muscularis propria alterations were seen in 25% of the two-application sites and 63% of the four-application sites (p<0.05). Increasing energy density from 12 to 20 J/cm2 did not correlate with a deeper ablation effect. Endoscopic ...Continue Reading

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Citations

Jun 12, 2014·Techniques in Coloproctology·F PigòR L Conigliaro
Feb 15, 2014·HIV Clinical Trials·A George SmulianStephen M Kralovic
Mar 18, 2017·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Arvind J TrindadeVivek Kaul
Aug 19, 2015·United European Gastroenterology Journal·Aymeric BecqXavier Dray
Jan 16, 2013·Therapeutic Advances in Gastroenterology·Rodney Eddi, Joseph R Depasquale
Jul 9, 2017·Journal of Biomedical Optics·Hsiang-Chieh LeeJames G Fujimoto
Jan 1, 2014·Diagnostics·Tsung-Han TsaiHiroshi Mashimo
May 22, 2019·Journal of Gastroenterology and Hepatology·Thomas R McCartyTarun Rustagi

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