Cryosurgery

Cryosurgery is also known as cryoablation, cryosurgical ablation or cryotherapy. It is a surgery which involves the usage of extreme cold produced by liquid nitrogen or carbon dioxide to freeze and destroy abnormal cells in the body.

Previously, it is used to treat the tumors present outside of the body but nowadays it is also used for the treatment of internal tumors. Cryotherapy is a procedure in which an extremely cold liquid or an instrument (called cryoprobe) is cooled with substances such as liquid nitrogen, liquid nitrous oxide, or compressed argon gas to freeze and destroy abnormal tissue. Cryotherapy is used to treat both cancer cells and going to be cancer cells.

In case of external surgery, the liq. Nitrogen is applied directly to the cancer cells with a cotton swab or spraying device, this is mostly used in the skin. But in internal tumors, the liq. Nitrogen is circulated through a hollow instrument (cryoprobe) which is placed in contact with the tumors. The surgeons use ultrasound or MRI to guide the cryoprobe and monitor the freezing of the cells, thus limits the damaging of the nearby healthy cells/tissues.

(In ultrasound, sound waves are bounce off on organs and other tissues to form a picture i.e. sonogram.) A ball of ice crystals forms around the probe and solidify the adjacent cells. Now and then more than one probe is utilized to convey the liquid nitrogen to various parts of the tumor. The probes may be put into the tumor during surgery or through the skin (percutaneously). After cryosurgery, the solidified tissue defrosts and is either normally ingested by the body (for inside tumors), or it breaks down and forms a scab (for outside tumors).

Types:

Cryosurgery is used to treat several types of cancer and a few precancerous or noncancerous conditions. In addition to prostate and liver tumors, cryosurgery can be a viable treatment for the following:

1.    Retinoblastoma (a childhood cancer affects the retina of the eye). Surgeons found that cryosurgery is most effective when the tumor is small and only in certain parts of the retina.

2.    Early-stage skin cancers (both basal cell and squamous cell carcinomas).

3.    Precancerous skin growths are known as actinic keratosis. Precancerous conditions of the cervix known as cervical intraepithelial neoplasia (when abnormal cell develops in the cervix it leads to cervical cancer).

Benefits vs. Risks?

Benefits

1.    In an open surgical approach, the recovery period of kidney and liver tumor is less as compared to open, surgical removal of the tumor.

2.    But in the case of percutaneous cryotherapy, the patient may stay overnight or be released a few hours after the procedure (In some cases Overnight stays for pain control is usually not needed).

3.    Percutaneous cryotherapy is less traumatic than open surgery since only a small incision is needed to pass the probe through the skin, which limits damage to healthy tissue. Also, percutaneous cryotherapy is cheap and results in fewer side effects than open surgery. Usually, a patient resumes their daily living activities in 24 hours after the procedure, if not sooner. However, patient is not allowed for heavy lifting for several days after abdominal treatment.

4.   For the treatment of fibroadenomas, cryotherapy causes minimal scar tissue and no apparent post-treatment calcifications.

Risks

1.    Like several percutaneous strategies, bleeding may result—both from the cut and the solidifying of tissues such as the liver, kidney or lung.

2.    Damage to normal structures may happen. During liver cryotherapy, the bile ducts may be harmed. During kidney cryotherapy, the ureter or collecting framework may be harmed. The rectum may be damaged during prostate cryotherapy. Any treatment of the abdomen may result in damage to the bowel and cause a hole in the bowel, which may discharge bowel substance into the abdomen that can lead to potentially life-threatening infection. If solidifying happens to close the stomach, fluid can accumulate in the space around the lungs.

3.    In case the procedure is in or close the lung, the lung may collapse. Nerve damage may result. Totally solidified nerves can cause motor weakness or deadness in the region provided by the nerves. Complications related to medications, including anesthesia, managed during the procedure may occur. Women should continuously educate their doctor or x-ray technologist in case there's any possibility that they are pregnant.

4.   Specific possible complications related to the cryotherapy of prostate cancer: Permanent feebleness since nerves controlling sexual potency are commonly included within the freezing process. However, nerves can recover, resolving the issue in a few patients. While the patient is under anesthesia, a bladder tube is positioned to deplete pee until the swelling of the bladder neck—as a result of the procedure—resolves. May cause urethral sloughing; that is, blocking of the pee stream with dead tissue. Sloughing is diminished by keeping the urethra warm with sterile water circulating persistently through a catheter set in the urethra during the procedure.