Spray cryotherapy is a non-contact method of destroying unwanted tissue using low-pressure liquid nitrogen. The rapid freezing and thawing of spray cryotherapy evokes significant cellular damage through a variety of different pathways while leaving the extracellular matrix essentially unaffected and thus avoiding the potential for mechanical injury attendant to other forms of cryotherapy While the efficacy and application of this technology has been well documented in the field of gastroenterology, we present a single center experience utilizing this platform across various disciplines treating in the aerodigestive tract. These included Head and Neck Surgery, Thoracic Surgery, Gastroenterology and Pulmonology.
A retrospective chart review was conducted, and data collected on all patients who received spray cryotherapy at our institution over the preceding 12 months. Data were collected on safety and efficacy. Data were also collected on intra-procedural observations as well as follow up observations in those patients who had received spray cryotherapy at a prior time.
During that time period, more than 100 patients and more than 150 procedures were performed with spray cryotherapy. The therapy was well-tolerated across various disciplines with effective tissue eradication noted. Observations include effective hemostasis, altered tissue appearance after treatment and the lack of bystander effect on adjacent structures. The primary differences across fields included minimum dosimetry for tissue destruction as well as alterations in dosimetry when using the technology to achieve other endpoints such as analgesia or hemostasis. One adverse event was noted, a 5% pneumothorax that resolved spontaneously in a patient who had a foreign body removed and was instrumented prior to the administration of the spray cryotherapy.
The observations from various disciplines suggest that spray cryotherapy is both an effective primary modality for tissue eradication as well as a valuable adjunctive modality in the setting of surgery to achieve hemostasis, analgesia and an alteration in the wound response.
Spray cryotherapy appears to be effective as a general use tool in the aerodigestive tract and chest.
William Krimsky, Shareholder Reset Medical; Consultant fee, speaker bureau, advisory committee, etc. Advisor and consultant to Reset Medical; Product/procedure/technique that is considered research and is NOT yet approved for any purpose. Spray cryotherapy for non-gastrointestinal procedures.