The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 543-549, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Morphologic and functional effects of esophageal cryotherapy
BM Rodgers, AP McDonald, JL Talbert and WH Donnelly
With advances in equipment design, cryotherapy has been applied
increasingly in the management of various integumentary disorders.
Recently, endobronchial cryotherapy has been utilized in the treatment of
acquired tracheal strictures. To evaluate the effects of cryotherapy upon
the esophagus, we cooled the distal esophagus of 12 cats to -70 degrees to
-80 degrees C. for 2 minutes with a specially constructed cryoprobe. The
animals were put to death in pairs 90 minutes, 4 days, 10 days, 14 days, 28
days, and 42 days following cryotherapy. Immediately prior to sacrifice,
all animals were studied with esophageal cinefluoroscopy and esophageal
manometrics. All animals tolerated this degree of cryotherapy and gained
weight on an ad libitum diet. Manometric studies demonstrated diminished
amplitude of peristalsis immediately following cryotherapy, but prompt
return to a normal manometric pattern. There was no evidence of esophageal
dysfunction on esophageal cinefluoroscopy. Morphologic examination
demonstrated superficial ulceration between 4 and 10 days following
cryotherapy, with subsequent healing. The esophagus in animals put to death
28 and 42 days following cryotherapy appeared histologically normal. These
studies demonstrate the safety of cryotherapy to -70 to - 80 degrees C.
upon the esophageal wall and suggest investigation of the usefulness of
this modality in the treatment of local esophageal webs and strictures.
