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Feasibility study of endoscopic thermal coagulation with circumferential laser irradiation for treating esophageal tissue

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Abstract

Barrett’s esophagus (BE) is associated with an intestinal metaplasia that replaces normal squamous epithelium by columnar epithelium. The aim of the current study was to evaluate the feasible endoscopic treatment on esophageal tissue with circumferential laser irradiation. A 532-nm laser was used to deliver 10 W in a continuous manner through a balloon catheter-integrated diffuser. Ex vivo leporine esophagus was tested to identify thermal responses at various irradiation times. In vivo testing in a porcine model was performed to evaluate the feasibility of endoscopic application with the integrated device for BE treatment. Goniometric measurements confirmed that the proposed device yielded uniform radial irradiation (i.e., 0.9 ± 0.1 in arbitrary unit). Emission profiles were well correlated with temperature distribution along the device. Ex vivo leporine testing demonstrated that the temperature rise increased with irradiation time. The maximum temperature increase was around 38 °C after 60-s irradiation (transient increase rate = 0.62 °C/s), and the corresponding thermal coagulation reached esophageal submucosa (1.5 ± 0.2 mm). In vivo porcine testing evidently presented circumferential thermal denaturation around the lumen along with mild inflammatory reaction and the degenerated squamous epithelium. The overall thickness of the irreversible thermal coagulation was 3.1 ± 0.2 mm. The proposed photothermal therapy can be a feasible endoscopic method to treat BE with the aid of circumferential irradiation and mechanical expansion. Further chronic in vivo testing will be pursued to understand chronic tissue response in terms of wound healing and complication.

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Acknowledgment

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C1017).

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea

    Seok Jeong

  2. National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Incheon, Republic of Korea

    Seok Jeong

  3. Interdisciplinary Program of Marine-Bio, Electrical & Mechanical Engineering, Pukyong National University, Busan, Republic of Korea

    Jinoh Bak & Hyun Wook Kang

  4. Bluecore Company Co. Ltd, Busan, Republic of Korea

    Sung Min Kim

  5. Department of Biomedical Engineering, Pukyong National University, Busan, Republic of Korea

    Hyun Wook Kang

  6. Center for Marine-Integrated Biomedical Technology (BK21 Plus), Pukyong National University, 45 Yongso-ro Nam-gu, Busan, 48513, Republic of Korea

    Hyun Wook Kang

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  1. Seok Jeong
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Correspondence to Hyun Wook Kang.

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Jeong, S., Bak, J., Kim, S.M. et al. Feasibility study of endoscopic thermal coagulation with circumferential laser irradiation for treating esophageal tissue . Lasers Med Sci 35, 893–900 (2020). https://doi.org/10.1007/s10103-019-02877-3

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  • DOI: https://doi.org/10.1007/s10103-019-02877-3

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