Reversible electroporation (REP) is a non-thermal technique that uses electrical pulses to induce transient pores in cellular membranes, facilitating the intracellular delivery of cytotoxic agents and promoting apoptosis. Its application in gastrointestinal neoplasms as a palliative treatment is promising, although data on its safety and efficacy are limited.

AIMS: To evaluate the safety and efficacy of REP in the palliative treatment of gastrointestinal neoplasms.

A multicenter observational, descriptive, study with prospective follow-up was conducted. Patients with gastrointestinal neoplasms presenting with bleeding, obstructive symptoms, or requiring palliative treatment due to frailty, lack of response, or contraindication to surgery, chemotherapy, or radiotherapy were included.

Forty REP sessions were performed in 25 patients (18 men, 7 women), with a mean age of 75 years and high comorbidity (ASA III/IV in 76%). Fifty-six percent of patients had metastatic disease, and 26% had locally advanced disease. The most frequent tumor sites were gastric (64%), esophageal (25%), duodenal, and rectal. The main indications were bleeding (76%), pain, and obstructive symptoms. As cytotoxic agent, intratumoral calcium was used in 80% of cases and intravenous bleomycin in the remaining 20%. Adverse events were mild (Agree grade I) and infrequent (16%). Technical success was 92% and clinical success was 75%. Fourteen patients (58%) died during follow-up, mainly due to tumor progression (71%). No procedure-related mortality was recorded

Reversible electroporation is a safe technique with a low incidence of adverse events and encouraging clinical outcomes in the palliative treatment of advanced  gastrointestinal neoplasms. Its use may represent a therapeutic alternative for frail patients or those lacking conventional  treatment options.