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Gastrointestinal endoscopy, once solely a diagnostic tool, is undergoing a transformation thanks to a novel technique that employs power-washing to collect cytology specimens from the stomach. In a pioneering proof-of-concept study, researchers have demonstrated the potential of this innovative approach in enhancing gastric cancer screening and surveillance.
Led by Dr. Charles J. Lightdale and his team at Columbia University Irving Medical Center, the study harnessed the power of a high-pressure liquid spray delivered via the ERBEJET flexible probe. This method, akin to power-washing, aims to systematically dislodge cells from the gastric mucosa, offering an alternative to laborious and time-consuming random biopsies.
The technique involves directing a high-pressure liquid spray at the gut, with pressure set to 10 bar, while employing sweeping and painting motions to ensure comprehensive coverage. The dislodged cells are then collected from pools of liquid, preserved in formalin, and sent to the lab for analysis.
In the study involving nine patients undergoing endoscopy for gastric cancer screening or surveillance, power-washing demonstrated promising results. The procedure, which added a mere 7-10 minutes to standard endoscopy time, yielded satisfactory cytology samples characterized by multiple strips and large clusters of cells.
Importantly, power-washing detected gastric intestinal metaplasia (GIM) and dysplasia in several patients, showcasing its potential as a valuable screening tool. While further research is needed to validate its efficacy compared to standard biopsy protocols, the initial findings underscore the promise of this innovative approach.
Dr. Lightdale and his team envision a future where power-washing, possibly coupled with artificial intelligence, revolutionizes gastric cancer screening and surveillance. They are already exploring modifications to the technique, including catheter designs that enhance efficiency and allow for simultaneous spray and suction, paving the way for targeted sampling of specific gastric regions.
Despite the optimism surrounding this groundbreaking technique, caution is warranted. While power-washing appears safe for most patients, individuals with certain medical conditions may not be suitable candidates. Nevertheless, the potential benefits in terms of improved detection rates and reduced morbidity and mortality from gastric cancer are undeniable.
Supported by funding from prominent philanthropic organizations, including Dalio Philanthropies and the Price Family Foundation, this study represents a significant step forward in the quest to combat gastric cancer. As researchers continue to refine and expand upon this innovative approach, the future of gastrointestinal endoscopy holds promise for more effective screening and surveillance protocols.
