Endoscopic and histologic observations following BICAP probe application in a canine model

Treatment of esophageal cancer using a BICAP Tumor Probe (BTP) is a recently described technique. To date, the major untoward side effects have been perforation and stricture formation. to investigate these problems further and to get a better understanding of the normal tissue response to bipolar electrocoagulation delivered in this manner, studies were carried out in a canine model. Both acute and chronic changes were examined. The standard BTP is 360°. A prototype 270° probe was developed to determine whether stricture formation and perforation were less apt to occur with the modified probe. Endoscopic evidence of coagulation and stricture formation was observed acutely but resolved with time. Histologically, the tissue injury was apparent at a depth of 1.5 mm, generally one-third of the esophageal wall thickness. One dog in the chronic group treated with the 270° probe died at 6 weeks after a tracheo-esophageal fistula developed.