Cryosurgery Introduction

You have cancer .But you also have options .Thanks to new advances in ultrasound imaging and freezing technology , patients of all ages are now leading active lives soon after cancer Treatment. Physically active. Emotionally active. Without resorting to radical surgery or radiation. Because it is often an outpatient procedure , It's not  just Life-Saving. It's lifestyle-saving.

The application of cold on human tissue is an ancient and well known technique used for the treatment of various injuries: in the 2500 BC the ancient Egyptians used ice packs on wounds and injuries to alleviate the pain.

From analgesic effect for a generic orthopedic trauma, it turned to study the effect of the cold on other types of diseases. Since the 19th century, it has been conducted many studies to prove the effectiveness of the ablation of tissue and, in 1840 in England , Dr. Arnott was the first to use cryosurgery to treat cancer.

However, the first of the '900 must wait for a better mastery of technique when, thanks to technological advances in the management and distribution of liquid gas, they began to actively treat oral cancer and skin. During the early 60s he began to have the first of cryosurgery instruments that used liquid nitrogen as the cryogen. In 1968 Gonder and Soans introduced cryoablation of the prostate gland resulting in destruction of the necrotic tissue. In 1970 Dr. Bonny related his experience of 229 patients treated in the field of cryosurgical. His report made ​​it known to the academic world that patients treated with this method, in each stage of the disease, had the same chances of survival in the long term than those treated with radical prostatectomy. However because of the difficulty in controlling the characteristics of cooling and heating, such equipment was only used in clinical applications that did not require a high level of accuracy. In 1988 Dr. Onik relate to the possibility to monitor in real time the treated using new ultrasound equipment.Subsequently Bahne doctors and Lee, in 1994, introduced further improvements to the technique, also favored by the continuous progress made in the field radiological, and technology used for this type of therapy.

Over the last few decades hence, cryoablation has greatly refined: the cold generators were equipped with computerized systems to fine-tune the supply of gas or liquid refrigerants and cryogenic probes have been miniaturized to be less invasive. Also today we enjoy the "opportunity to see" inside the human body through ultrasound, CT, MRI, PET and so on. We can then identify the sick tumor areas, perform much more precise biopsies thanks to the Fusion Biopsy and drive within them the cryogenic probes;Moreover the images allow us to monitor the tissue while being cooled by the cryogen injected by cryoprobes. In this way we avoid damage to nearby organs, and we can hit so regulated and selective tumors.

How cryosurgery works

 

Franco Lugnani, MD

“I'm extremely happy with the results on my patients over the last 10 years, and I've achieved excellent long-term [results].”

I recommend cryosurgery to all my patients, no matter what volume disease they have, as long as it's localized because I can [treat] them in a very safe manner, and this is what my patients are requesting.

I feel cryosurgery really is in the forefront, and in my experience, I found it to be extremely effective. I've seen dramatic changes not only in the long-term [results] now that I've been able to follow these patients, but also because the technology is improving.

And importantly, my patients do not have to worry about the costs because cryosurgery is covered by Medicare and most major HMOs.

  • Technical History

    James Arnott was the first, in 1845, to make use of the destructive effect of freezing in the treatment of cancer (Gage 1992). Frozen salt solutions (-18°C and -22°C) were used to treat advanced carcinomas of the breast and of the uterine cervix. The described benefits were lessening of pain, James Arnott was the first, in 1845, to make use of the destructive effect of freezing in the treatment of cancer (Gage 1992). Frozen salt solutions (-18°C and -22°C) were used to treat advanced carcinomas of the breast and of the uterine cervix. The described benefits were lessening of pain,

  • Cryoablation Features

    Cryosurgery causes tissue destruction and cell death by means of various direct and indirect mechanisms. Direct cell damage is the physical and chemical result of intracellular ice formation combined with extracellular ice formation and solute-solvent changes which first cause dehydration and then massive rehydration, followed by osmotic lysis of the cells. Indirect damage arises not only when cells lose their integrity but also from alterations in the single-layer endothelium of the vascular lumen and from the consequent platelet aggregation and disseminated microthrombosis of the capillaries, resulting in ischaemic necrosis and hypoxaemia. In the case of direct damage from rapid cooling, the mechanism is primarily triggered by the formation of ice crystals inside the cytoplasm. In the case of indirect damage, the mechanism is triggered by the formation of osmotic contragradients in the different phases of cooling first and of warming afterwards. Actually, the freezing process starts with the generation of ice crystals in every interstitial compartment and therefore the withdrawal of their aqueous component that results in cell dehydration. Cell death takes place in the subsequent warming phase, when the cells are killed by a mechanism known as "solution" or osmotic effect. When the ice crystals in the interstitial tissues melt, the shrunken cells, that have high saline contents, attract water. But the damage to the membranes and to their compensatory mechanisms added to the instantaneousness of the phenomenon, cause the cells to swell so rapidly that they explode.

  • Principles

    Cryosurgery offers advantages over other methods of cancer treatment. It is less invasive than surgery, involving only a small incision or insertion of the cryoprobe through the skin. Consequently, pain, bleeding, and other complications of surgery are minimized. Cryosurgery offers advantages over other methods of cancer treatment. It is less invasive than surgery, involving only a small incision or insertion of the cryoprobe through the skin. Consequently, pain, bleeding, and other complications of surgery are minimized.