Endoscopic Electroporation for Controlling Bleeding and Stenosis Secondary to Digestive Tract Cancer: Experience in a Tertiary Hospital

Aims Electroporation is an effective method for treating cutaneous tumors. With the development of new devices, its application to gastrointestinal tumors shows promising results. Calcium electroporation uses short electrical pulses to increase membrane permeability, allowing high doses of calcium to induce cellular necrosis. The aims are:

1. Evaluate the usefulness of intratumoral calcium electroporation in controlling bleeding secondary to gastrointestinal neoplasms.

2. Assess the efficacy of intratumoral calcium electroporation in managing neoplasm stenosis.

Methods Seven patients, aged 67–91 years (mean age 80), were included between November 2022 and November 2024. All had multiple comorbidities and either metastatic or locally advanced neoplastic disease, where standard treatment was either deemed unsuitable or combined with palliative oncological care. Electroporation was performed using the EndoVe device (Mirai Medical, Galway, Ireland) after intratumoral injection of calcium chloride or calcium gluconate (0.5 ml/cm³, calculated as (ab²π/6), where*a*is the longest tumor diameter and*b*is the perpendicular diameter).

Results The cohort included six patients with esophagogastric adenocarcinoma and one with rectal adenocarcinoma. The mean tumor size was 64 mm (range 40–80 mm). Patients were followed up for an average of six months (range 0–12 months). Six patients presented with anemia and gastrointestinal bleeding due to the neoplasia. Two patients experienced dysphagia secondary to the tumor. Electroporation could not be performed in one patient due to device passage limitations. Four patients underwent a single session of electroporation; two required 2–3 sessions, spaced five weeks apart, due to persistent symptoms. Pre- and post-treatment blood analyses showed a mean initial hemoglobin (Hb) level of 9.2 g/dL (range 8–12.1 g/dL), increasing to 11.5 g/dL (range 10.4–13.7 g/dL) post-treatment. No adverse events were reported. A median survival of 5.2 months (range 0–12 months). Two patients remain under follow-up. Only two patients required red blood cell transfusions during follow-up, and none required an endoluminal stent.

Conclusions - Intratumoral calcium electroporation is a safe treatment for gastrointestinal tumors.

• It is effective in controlling bleeding and stenosis caused by digestive neoplasms, offering a simple and safe alternative to existing palliative options.

• Calcium electroporation can be combined with other treatment modalities without increasing complications.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025