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Monday Poster Session

Category: Esophagus

P2779 - Prolonged Duration of Liquid Nitrogen Spray Cryotherapy Is Safe in Esophageal Cancer

Monday, October 27, 2025
10:30 AM - 4:00 PM MT
Location: Exhibit Hall

    Presenting Author(s)

  • Nikita Chadha, DO

    Virginia Commonwealth University Health System
    Richmond, VA

Nikita Chadha, DO1, Lauren Szeto, MD2, Joseph Spataro, MD3
1Virginia Commonwealth University Health System, Richmond, VA; 2Virginia Commonwealth University Medical Center, Richmond, VA; 3Hunter Holmes McGuire VA Medical Center, Richmond, VA

Introduction: Liquid nitrogen spray cryotherapy (LNSC) is a thermal therapy aimed to achieve destruction of abnormal tissue in the gastrointestinal tract using freezing cold temperatures. It has been shown to effectively palliate malignancy induced dysphagia. Current practice suggests a 30 second spray per cycle duration; however, this approach is extrapolated from porcine models. The lack of proper studies has led to an inconsistent use. In the absence of dosimetry, its uptake into regular practice has been hampered by its concern for an increased liability. This study aims to evaluate the safety of prolonged spray cryotherapy in Veterans with esophageal cancer.

Methods: This single-center, IRB approved, retrospective study was performed at a Veterans Affairs Medical Center. A single US board-certified faculty member performed upper endoscopy with LNSC in Veterans with malignancy induced dysphagia. Data collection for each session of cryotherapy included the number of treatment sites, number of ablation cycles per site, duration of spray time, and complications. Spray time was defined as the total duration of application of LNSC on the targeted tissue. Treatment duration was determined by visual effect (i.e. hyperemic mucosa).

Results: A total of 32 procedures were included. There was an average of 2.2 sites treated per session, 3.2 ablation cycles per site, and a spray time for each cycle of 101.4 seconds. There were no complications associated with these procedures which included: intestinal perforation, intestinal hemorrhage requiring intervention, stricture development, or post procedure discomfort not alleviated by topical therapy.

Discussion: Prolonged spray times using liquid nitrogen spray cryotherapy for esophageal cancer is proven to be safe and well tolerated. Further research is needed to discern dosimetry and ideal spray times.

Disclosures:
Nikita Chadha indicated no relevant financial relationships.
Lauren Szeto indicated no relevant financial relationships.
Joseph Spataro indicated no relevant financial relationships.

Nikita Chadha, DO1, Lauren Szeto, MD2, Joseph Spataro, MD3. P2779 - Prolonged Duration of Liquid Nitrogen Spray Cryotherapy Is Safe in Esophageal Cancer, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.