Minimally invasive cryosurgery - Technological advances
Minimally invasive cryosurgery - Technological advances
复制标题
DOI：
10.1006/cryo.1997.2017
复制
发表时间：
1997-06-01
期刊：
影响因子：
2.7
通讯作者：
Zhang, CM
中科院分区：
文献类型：
--
作者：
Baust, J;Gage, AA;Zhang, CM
引起人们对冷冻手术重新关注的技术进步是术中超声监测治疗过程的发展以及设计使用过冷液氮的新型冷冻手术设备的发展。这种薄而高效的探针有多种尺寸，可以通过内窥镜或经皮微创手术植入病变部位。使用方法是在超声引导下将探针放置在病变组织中的所需位置。如果肿瘤的大小或位置需要，可以同时插入多达五个探针并冷却到-195摄氏度。冷冻过程由超声监测，当组织被冷冻时，超声显示低回声（暗）图像。快速冻结、缓慢解冻和反复的冻结/解冻循环是该技术的标准特征。近4年来在前列腺癌和肝脏肿瘤的治疗方面的临床应用越来越普遍。选择冷冻手术的病例通常是那些无法进行常规治疗的病例。然而，特别是前列腺癌，手术发病率很低，治疗结果在短期内足够好，值得考虑在疾病的早期阶段使用。其他部位的各种肿瘤，如脑、支气管、骨、胰腺、肾脏和子宫，也有少量采用冷冻手术治疗。从这一经验来看，进一步扩大冷冻手术技术的应用似乎是肯定的。(C) 1997学术出版社。
The technological advances which have caused renewed interest in cryosurgery are the development of intraoperative ultrasound to monitor the therapeutic process and the development of new cryosurgical equipment designed to use supercooled liquid nitrogen. The thin, highly efficient probes, available in several sizes, can be placed in diseased sites via endoscopy or percutaneously in minimally invasive procedures. The manner of use is to place the probe in the desired location in the diseased tissue with ultrasound guidance. If required by the size or location of the tumor, as many as five probes can be inserted and cooled to -195 degrees C simultaneously. The process of freezing is monitored by ultrasound which displays a hypoechoic (dark) image when the tissue if frozen. Rapid freezing, slow thawing, and repetition of the freeze/thaw cycle are standard features of technique. Clinical applications which have become common in the past 4 years include the treatment of prostatic cancer and liver tumors. The cases selected for cryosurgery are generally those for which no conventional treatment is possible. However, especially in prostatic cancer, the operative morbidity is so low and the results of therapy are sufficiently good in the short term to merit consideration of use in earlier stages of the disease. Diverse tumors in other sites, such as the brain, bronchus, bone, pancreas, kidney, and uterus, have also been treated in small numbers by cryosurgery. Judging from this experience, further expansion in the use of cryosurgical techniques seems certain. (C) 1997 Academic Press.