Popken Frank, Land Marc, Erberich Heike, Bosse Marfalda, König Dietmar-Pierree, Eysel Peer
Department of Orthopedic Surgery, University of Cologne, Josef-Stelzmann-Str, 9, 50931 Cologne, Germany.
BMC Surg. 2003 Apr 22;3:3. doi: 10.1186/1471-2482-3-3.
So far, modern miniature cryoprobes were used for local destruction of soft tissue tumours without damaging the adjacent healthy tissue. In this study, cryoablation methodology was applied to bone and the cooling capacity of the probe was examined in vitro and in vivo.
Freezing was performed by cooling one or two probes (diameter 3.2 mm) to -180 degrees C with liquid nitrogen. The cooling capacity of the probes was determined optically and thermally against a homogeneous reference gel, followed by in vivo measurements on femoral and tibial sheep bone followed by histological examination.
Thanks to the synergistic effect, the simultaneous use of 2 probes produced an almost spherical expansion of cold in the homogenous gelatin. During the in vivo freezes, the temperature curves showed a more moderate trend. Nevertheless, due to the synergistic effect, temperatures below -50 degrees C could be reached at a distance of 1 cm from the probe. No local or systemic intraoperative complications were observed. Histological examination revealed cell necrosis up into the -10 degrees C isotherm.
Adequate tissue cooling of the bone matrix can be achieved with in vivo freezes by means of one or more miniature cryoprobes. Therefore, this probe could provide an alternative to or supplement surgical resection of pathological bone processes.
迄今为止,现代微型冷冻探头已用于软组织肿瘤的局部破坏,而不会损伤相邻的健康组织。在本研究中,将冷冻消融方法应用于骨骼,并在体外和体内检查了探头的冷却能力。
通过用液氮将一个或两个探头(直径3.2毫米)冷却至-180摄氏度来进行冷冻。针对均匀的参考凝胶,通过光学和热学方法确定探头的冷却能力,随后在绵羊股骨和胫骨上进行体内测量,然后进行组织学检查。
由于协同效应,同时使用2个探头可在均匀明胶中产生几乎呈球形的冷扩散。在体内冷冻过程中,温度曲线显示出较为平缓的趋势。然而,由于协同效应,在距探头1厘米处可达到低于-50摄氏度的温度。未观察到局部或全身术中并发症。组织学检查显示,在-10摄氏度等温线以上出现细胞坏死。
通过一个或多个微型冷冻探头在体内进行冷冻,可以实现对骨基质的充分组织冷却。因此,这种探头可为病理性骨病变的手术切除提供替代方法或补充手段。