Cryosurgery of the prostate: techniques and indications.
Cryosurgery of the prostate: techniques and indications.
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发表时间：
2004
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通讯作者：
Jeffrey K. Cohen
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作者：
Jeffrey K. Cohen
冷冻外科前列腺消融术(CSAP)适用于高分期和高级别肿瘤患者、前列腺癌体外放射治疗或近距离放射治疗后复发/持续的患者等。在阿勒格尼综合医院，CSAP的实施步骤如下：患者准备以夸张的取石位；通过直肠超声获得腺体的体积研究；通过17号阶梯安装的模板放置5至15根冷冻针(以3至5行水平)；进行膀胱镜检查；以及引入尿温导管。然后从前到后激活成排的冰冻针头，通常使用两个冻融周期。在较长的腺体中，可能需要拉回冰针以完全覆盖腺体的顶端部分。CSAP所需的技能与近距离治疗针放置所需的技能相同，因此对已经熟练掌握近距离治疗的医生所需的培训最少。
Cryosurgical ablation of the prostate (CSAP) is indicated for patients with high-stage and high-grade tumors, patients with recurrent/persistent carcinoma of the prostate after external radiation therapy or brachytherapy, and others. At Allegheny General Hospital, CSAP is performed as follows: the patient is prepped in an exaggerated lithotomy position; a volumetric study of the gland is obtained with transrectal ultrasound; 5 to 15 cryoneedles are placed (in three to five horizontal rows) through a 17-gauge, stepper-mounted template; a cystoscopy is performed; and a urethral warming catheter is introduced. The rows of cryoneedles are then activated from anterior to posterior, and generally two freeze-thaw cycles are used. In longer glands, a pullback of the cryoneedles might be needed to completely cover the apical portion of the gland. The skills required for CSAP are identical to those required for brachytherapy needle placement, thus the training required for physicians already proficient in brachytherapy is minimized.