Department of Urology, Columbia University Medical Center, New York, New York, USA.
J Endourol. 2010 Sep;24(9):1503-7. doi: 10.1089/end.2009.0587.
Contemporary cryoablation technology utilizes the Joule-Thomson effect, defined as a change in temperature that results from expansion of a nonideal gas through an orifice or other restriction. We evaluated the effect of initial gas tank pressures on freezing dynamics in a single-probe model and in a multiprobe model using contemporary cryoablation technology.
Cryoablation trials were performed in a standardized system of transparent gelatin molds at 25°C. Two sets of trials were performed. The first trial evaluated temperature and ice ball size for a given tank pressure when a single needle was deployed. The second trial recorded ice ball temperatures for each probe when multiple probes were fired simultaneously.
Trial 1: The rate of temperature change is directly related to the initial pressure of the gas being released, and the group with the highest starting pressures reached the lowest mean temperature and had the largest mean ice ball size (p < 0.01). Trail 2: Multiple-probe ablation did not affect the rate of temperature change or final temperature compared with firing a single probe (p > 0.7).
In accordance with the Joule-Thomson effect, higher initial gas pressures used for cryoablation in a transparent gel model demonstrate statistically significant lower temperatures, faster decreases in temperature, and formation of larger ice balls than lower gas pressures do. With contemporary technology, multiple simultaneous cryoprobe deployment does not compromise individual probe efficacy. The use of higher initial tank pressures will theoretically help future cryoprobes be more effective, creating a greater volume of cell necrosis and a smaller indeterminate zone.
当代的冷冻消融技术利用焦耳-汤姆逊效应,即通过孔口或其他限制使非理想气体膨胀而导致的温度变化。我们评估了初始气罐压力对单探针模型和多探针模型中冷冻动力学的影响,使用了当代冷冻消融技术。
在 25°C 的透明明胶模具标准化系统中进行冷冻消融试验。进行了两组试验。第一次试验评估了在单个探针部署时,给定气罐压力下的温度和冰球大小。第二次试验记录了多个探针同时发射时每个探针的冰球温度。
试验 1:温度变化的速率与释放气体的初始压力直接相关,起始压力最高的组达到了最低的平均温度和最大的平均冰球大小(p < 0.01)。试验 2:与发射单个探针相比,多探针消融并不会影响温度变化率或最终温度(p > 0.7)。
在透明凝胶模型中,根据焦耳-汤姆逊效应,冷冻消融中使用较高的初始气体压力会显著降低温度、更快地降低温度并形成更大的冰球,而较低的气体压力则不会。使用当代技术,多个同时的冷冻探针部署不会影响单个探针的疗效。使用较高的初始气罐压力理论上可以帮助未来的冷冻探针更有效,形成更大的细胞坏死体积和更小的不确定区域。