Baust J, Gage A A, Ma H, Zhang C M
Center for Cryobiological Research State University of New York, Binghamton 13902, USA.
Cryobiology. 1997 Jun;34(4):373-84. doi: 10.1006/cryo.1997.2017.
The technological advances which have caused renewed interest in cryosurgery are the development of intraoperative ultrasound to monitor the therapeutic process and the development of new cryosurgical equipment designed to use supercooled liquid nitrogen. The thin, highly efficient probes, available in several sizes, can be placed in diseased sites via endoscopy or percutaneously in minimally invasive procedures. The manner of use is to place the probe in the desired location in the diseased tissue with ultrasound guidance. If required by the size or location of the tumor, as many as five probes can be inserted and cooled to -195 degrees C simultaneously. The process of freezing is monitored by ultrasound which displays a hypoechoic (dark) image when the tissue if frozen. Rapid freezing, slow thawing, and repetition of the freeze/thaw cycle are standard features of technique. Clinical applications which have become common in the past 4 years include the treatment of prostatic cancer and liver tumors. The cases selected for cryosurgery are generally those for which no conventional treatment is possible. However, especially in prostatic cancer, the operative morbidity is so low and the results of therapy are sufficiently good in the short term to merit consideration of use in earlier stages of the disease. Diverse tumors in other sites, such as the brain, bronchus, bone, pancreas, kidney, and uterus, have also been treated in small numbers by cryosurgery. Judging from this experience, further expansion in the use of cryosurgical techniques seems certain.
引发对冷冻手术重新产生兴趣的技术进步包括术中超声用于监测治疗过程的发展，以及旨在使用过冷液氮的新型冷冻手术设备的开发。这种细而高效的探头有多种尺寸可供选择，可通过内窥镜检查置于病变部位，或在微创手术中经皮放置。使用方法是在超声引导下将探头置于病变组织的所需位置。根据肿瘤的大小或位置要求，可同时插入多达五个探头并将其冷却至-195摄氏度。冷冻过程通过超声监测，当组织冷冻时，超声显示低回声（暗）图像。快速冷冻、缓慢解冻以及冻融循环的重复是该技术的标准特征。在过去4年中已变得常见的临床应用包括前列腺癌和肝肿瘤的治疗。选择进行冷冻手术的病例通常是那些无法进行传统治疗的病例。然而，特别是在前列腺癌中，手术发病率很低，且短期内治疗效果足够好，值得考虑在疾病的早期阶段使用。其他部位的各种肿瘤，如脑、支气管、骨、胰腺、肾和子宫，也有少数通过冷冻手术进行了治疗。从这一经验来看，冷冻手术技术的使用进一步扩大似乎是肯定的。
