Gage A A, Baust J
The Department of Surgery, State University of New York, Buffalo, New York, 14214, USA.
Cryobiology. 1998 Nov;37(3):171-86. doi: 10.1006/cryo.1998.2115.
As the modern era of cryosurgery began in the mid 1960s, the basic features of cryosurgical technique were established as rapid freezing, slow thawing, and repetition of the freeze-thaw cycle. Since then, new applications of cryosurgery have caused numerous investigations on the mechanism of injury in cryosurgery with the intent to better define appropriate or optimal temperature-time dosimetry of the freeze-thaw cycles. A diversity of opinion has become evident on some aspects of technique, but the basic tenets of cryosurgery remain unchanged. All the parts of the freeze-thaw cycle can cause tissue injury. The cooling rate should be as fast as possible, but it is not as critical as other factors. The coldest tissue temperature is the prime factor in cell death and this should be -50 degreesC in neoplastic tissue. The optimal duration of freezing is not known, but prolonged freezing increases tissue destruction. The thawing rate is a prime destructive factor and it should be as slow as possible. Repetition of the freeze-thaw cycle is well known to be an important factor in effective therapy. A prime need in cryosurgical research is related to the periphery of the cryosurgical lesion where some cells die and others live. Adjunctive therapy should influence the fate of cells in this region and increase the efficacy of cryosurgical techniques.
随着冷冻外科的现代时代始于20世纪60年代中期，冷冻外科技术的基本特征被确立为快速冷冻、缓慢解冻以及冻融循环的重复。从那时起，冷冻外科的新应用引发了对冷冻外科损伤机制的大量研究，旨在更好地确定冻融循环合适的或最佳的温度-时间剂量。在技术的某些方面，观点的多样性已经变得明显，但冷冻外科的基本原则保持不变。冻融循环的所有部分都可导致组织损伤。冷却速率应尽可能快，但它不像其他因素那样关键。最冷的组织温度是细胞死亡的主要因素，在肿瘤组织中这一温度应为-50℃。冷冻的最佳持续时间尚不清楚，但延长冷冻会增加组织破坏。解冻速率是一个主要的破坏因素，应尽可能缓慢。众所周知，冻融循环的重复是有效治疗的一个重要因素。冷冻外科研究的一个主要需求与冷冻外科损伤的周边有关，在那里一些细胞死亡而另一些细胞存活。辅助治疗应影响该区域细胞的命运并提高冷冻外科技术的疗效。
