Moore Ryan F, Lile Deacon J, Abbas Abbas E
Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
J Thorac Dis. 2017 Mar;9(Suppl 2):S122-S129. doi: 10.21037/jtd.2017.01.55.
The use of liquid nitrogen to treat skin and mucosal lesions is well understood in the dermatologic and gastrointestinal literature. Direct spray cryotherapy (SCT) in the airway has shown promising results in the treatment of esophageal premalignant and even invasive lesions. In the airway, several studies have shown it to be a safe, effective treatment for both benign and malignant disease. It is easily administered in the outpatient setting and can be repeated several times without undue side effects. In this article, we review the current literature on the use of SCT for the treatment of endobronchial lesions and also describe our own institutional experience of the use of SCT in the airway. The use of proper technique and airway venting is important in mitigating the complications of barotrauma from massive expansion of nitrogen upon conversion from the liquid to gaseous state. We also review some of the basic science principals behind the use of the cryotherapy to treat lesions in different tissues. We feel that SCT is a potential area for further research at both clinical and basic science level.
在皮肤科和胃肠病学文献中，使用液氮治疗皮肤和粘膜病变已为人熟知。气道直接喷雾冷冻疗法（SCT）在治疗食管癌前病变甚至浸润性病变方面已显示出有前景的结果。在气道方面，多项研究表明它对良性和恶性疾病都是一种安全、有效的治疗方法。它易于在门诊环境中实施，并且可以重复多次而不会产生过多副作用。在本文中，我们回顾了关于使用SCT治疗支气管内病变的当前文献，并描述了我们自己机构在气道中使用SCT的经验。采用适当的技术和气道通气对于减轻液氮从液态转变为气态时大量膨胀引起的气压伤并发症很重要。我们还回顾了冷冻疗法用于治疗不同组织病变背后的一些基础科学原理。我们认为SCT在临床和基础科学层面都是一个有进一步研究潜力的领域。
