Cryosurgery

Cryosurgery is one of the newest and most promising methods of treating malignant and benign neoplasms, allowing effective destruction of tumors of various localization. In 2024, the EMC Surgical Clinic began using the latest generation of high-tech equipment to perform minimally invasive cryosurgical operations.

In which cases cryosurgery is used

Cryosurgery is used to treat such types of cancer as:

• skin cancer;

• skin lesions in HIV-associated Kaposi's sarcoma;

• prostate cancer at an early stage;

• malignant liver tumors;

• bone cancer;

• non-small cell lung cancer;

• oral cancer;

• colon cancer;

• pancreatic cancer;

• kidney cancer;

• brain tumors.

The method is applicable for precancerous conditions or tumors with a risk of malignancy, including:

• actinic keratosis;

• intraepithelial neoplasia of the cervix;

• bone neoplasms (enchondroma, giant cell tumor of bone, chondroblastoma).

In addition, the method shows good effectiveness in various benign formations, including:

• vascular malformations;

• skin hemangiomas;

• keloid scars.

Indications

Cryosurgery is used in cases where:

• The tumor cannot be surgically removed due to its location;

• surgical treatment of the patient is difficult due to his advanced age or concomitant pathologies (diabetes, impaired kidney function, severe cardiovascular diseases);

• the patient refuses surgery for psychological reasons or cosmetic consequences.

When is cryoablation possible?:

• malignant neoplasm of various localizations;

• tumor recurrence;

• the location of the tumor within the boundaries of the affected organ or with minimal overgrowth beyond its limits;

• the size of the tumor is not more than 5 cm (liver, kidney), up to 1.5cm (breast);

• as a palliative technique for tumors with metastases (bone metastases).

Most of the equipment used in the world produces an iceberg with a diameter of about 2 cm, and several injection probes are required to form a larger ice ball.

But science does not stand still, and the ProSense cryosystem of the latest generation based on liquid nitrogen (so far in Russia such equipment is available only in EMC) allows freezing formations with a diameter of up to a temperature of minus 185-190 degrees in  5 see

Indications also depend on the purposes of cryoablation. It can be applied to:

1. As the main treatment method. Cryosurgery is indicated for small tumors if they cannot be removed due to concomitant diseases or if the patient refuses standard surgery In combination with surgery. In some cases, it is more advisable to use two methods at once, for example, to reduce the burden on the patient. When operating on large tumors, cryosurgery can reduce bleeding and reduce the risk of cancer cell spread.
In combination with other treatment methods. In solid tumors, percutaneous cryoablation is used to reduce the size of the neoplasm and thereby increase the effectiveness of chemotherapy or radiation therapy. The method can also be used in conjunction with hormonal or immune therapy. For palliative purposes. "Tissue freezing helps to reduce pain in the late stages of cancer. The cryoablation method improves the quality of life of patients with metastatic tumors.

How is the procedure

The procedure method may differ slightly depending on the location of the tumor. The procedure is usually performed in cycles: the tissues are cooled to the target temperature, after which they are allowed to warm up a little and cooled again.

Puncture percutaneous cryoablation (percutaneous access).

In this case, the skin is punctured in the projection of a malignant neoplasm using a surgical stiletto. Next, the stiletto is extracted, and the&A cryoprobe is inserted through the puncture, through the tip of which cryogen is delivered to the tumor. The procedure is performed under the supervision of computed tomography or ultrasound.

Laparoscopic or thoracoscopic cryoablation.

In this case, the cryoprobe is also inserted through a puncture under the control of an endoscope. Microsurgical instruments and an endoscope are inserted through other punctures, which allows video monitoring of manipulations.

Side effects

In most cases, cryosurgery is well tolerated by patients. The side effects of treatment are moderate and usually disappear after a few days. Depending on the type and location of exposure, after the procedure, the patient may experience:

• soreness and discomfort in the area of the procedure;

• slight swelling;

• redness of the skin in the area of application of the cooling agent (in the treatment of skin growths);

• cough with a small amount of spotting (in the treatment of lung cancer;

• blood in urine in the treatment of kidney cancer.

Advantages of the procedure

1. Minimal injury. The risk of damage to healthy tissues is very low. Rehabilitation after the procedure does not take more than a few days and is easy.
You don't need to stay in the hospital. The procedure is usually performed on an outpatient basis, or a short-term hospitalization is required.
2. Security. It can be repeated the required number of times without risk to the patient and deterioration of his condition.
3. Versatility. The method is applicable in patients who do not tolerate other types of treatment well, and also in cases where cancer does not respond to standard therapy.