Roobottom C A, Jurriaans E, Lanigan D, Dubbins P A, Choa G
Department of Radiology, Derriford Hospital, Plymouth, Devon.
Clin Radiol. 1993 Oct;48(4):241-3. doi: 10.1016/s0009-9260(05)80304-6.
Cryoprostatectomy, the use of subzero temperatures to ablate prostate tissue gained favour in the 1960s because of its speed and lack of haemodynamic effects. It fell from use because the freezing process could not be monitored and this led to a high incidence of local complications. We have performed transrectal real time ultrasound in 12 patients undergoing cryoprostatectomy. In all the freezing process was easily visualized as an advancing hyperechoic 'iceball' with distal acoustic shadowing. Monitoring allowed maximum prostate ablation without breaching the prostatic capsule. There were no significant complications and all but one patient gained symptomatic relief. Ultrasound at 1 month showed a heterogeneous echo pattern with very little cavity formation but by 3 months a significant cavity was seen. This study demonstrates that it is possible to monitor the freezing process during transurethral cryoprostatectomy. This, theoretically, should significantly reduce the local complications encountered in previous studies.
冷冻前列腺切除术，即利用零下温度消融前列腺组织，因其速度快且无血流动力学影响，在20世纪60年代受到青睐。后来它不再被使用，因为冷冻过程无法监测，这导致局部并发症的发生率很高。我们对12例接受冷冻前列腺切除术的患者进行了经直肠实时超声检查。在所有病例中，冷冻过程很容易被可视化，表现为一个向前推进的高回声“冰球”并伴有远端声影。监测使得在不突破前列腺包膜的情况下实现最大程度的前列腺消融。没有明显的并发症，除1例患者外，所有患者的症状都得到了缓解。术后1个月的超声显示回声不均匀，几乎没有腔隙形成，但到3个月时可见明显的腔隙。这项研究表明，在经尿道冷冻前列腺切除术中监测冷冻过程是可行的。从理论上讲，这应该能显著减少以往研究中遇到的局部并发症。
