Cryosurgery

Surgeon Dr. Doping tells about surgical methods of treatment using frozen, open cryosurgery and "CyberKnife" system. When I first began to use cold during surgery? What methods are used for removing frozen tumors? How can I combine cryotherapy with increasing temperature?

Cryosurgery - this word is made up of two Greek words "cryo" - "freeze", "surgery" - all clear, but if translated literally, it is "crafts", that is "handmade". Accordingly, cryosurgery is a surgical treatment using frozen.

The story is very interesting, because since the time of Hippocrates, the ancient doctors, healers and even just ordinary people have noticed that if you cool some part of the body that hurts, the pain gradually reduced. Using cold long been known in medicine. If you again look at history, we see that in 1812 the famous surgeon Larrey, which is very respected by Napoleon Bonaparte, to perform operations on the battlefield, using cold. He noted that the French soldiers who were injured in the winter, much easier transferred amputation, almost did not feel the pain when the affected limb has been supercooled. It was like the beginning of what we have now.

If we look at the XIX century to the mid-XIX century, in 1851 year, Arnaud in England has used a mixture of ice and salt to lower the temperature of the ice in the treatment of cancer, such as breast cancer, skin cancer. And this method has been widely popular in Europe because it does reduce inflammation, swelling, pain, tumor growth is also decreased. In addition, further special devices have been invented in order to obtain stable ice lumps low temperature to -24 degrees, and it is used to treat various skin diseases. To treat skin disease – use Peptide complex for effective skin rejuvenation of the face and the entire body, Peptides Ovagen, Peptides Svetinorm.

In the last century, this method left in the official practice, because at mid-century devices have been invented which allow liquefied gas to low temperatures, in particular nitrogen to freeze -195 degrees. There was a special equipment, and it has been used in clinical practice. In particular, Cooper, neurosurgeon tried to freeze the brain tumor. It is in 1961, imagine. And then, this method has become quite popular.

However, for unknown reasons, the United States began to forget about this method of treatment. However, in Russia in the same period, in the 60's, our surgeons and scientists also drew attention to the healing quality of deep-frozen using liquid nitrogen, and the doctor Kandel used liquid nitrogen to freeze the brain tumors. If we compare priorities, who started first clinical use extremely low temperatures - Russia, then the Soviet Union, too, is in the cage.

In 70-ies formed cryosurgical Association in the United States, Europe and Japan. In 2013 it formed a cryosurgical Association in Russia. This shows the urgency of the problem. It brings together doctors of various specialties, which use extremely low temperatures in their practice.

In most cases, liquid nitrogen. Treatment with liquid nitrogen doctors of many specialties are now used: dermatologists, urologists, surgeons, operating in the abdominal cavity, oncology, traumatology, ENT doctors, gynecologists - you can access this list to continue, because thanks to cryosurgical associations all over the world that communicate with each other , various techniques are gradually finding its place in the treatment of many serious diseases. This also applies to malignant diseases, malignant tumors of the liver and pancreas. (Riboxin, Meldonium)

In Russia at the present time it is a priority of public cryosurgical operations on the liver, pancreas.

In most countries, particularly in Europe, the United States, China, Japan, using thin KHOLODOVA needle sensors or probes, that is, using a puncture, in order to convey cold to a particular affected organ, in particular, in prostate cancer . In our country, a popular method of open cryosurgery, where the diseased organ is exposed and made it an open freezing. This method manages to freeze large amounts of tumor. This requires special cryosurgical equipment, equipment that we have, and the quality is not worse, sometimes even ahead of their foreign counterparts.

Thus, cryosurgery is now occupied a strong position it in the treatment of a number of benign diseases that do not require the use of a scalpel and with the help of freezing you can remove some cosmetic blemishes on the skin. If we talk about cancers, then cryosurgery allows to achieve tumor regression, tumor growth inhibition in situations where surgically impossible to remove the tumor because of the prevalence of the process, ie the so-called locally advanced tumors, for example, pancreas, liver metastases, which we do not can remove, is now successfully treated with cryosurgical method.

Speaking about the prospects of cryosurgery, continuing the development of new equipment, in order to get the most efficient, fastest cooling method, achieve flexibility cryoprobe to achieve complex anatomical areas with open surgery, as well as the completion of puncture cryoprobe for the possibility of forming a puncture through the skin under ultrasound guidance or computed tomography, or magnetic resonance imaging, and the achievement of cryosurgical effect without open surgery. In our country, the development of this equipment is engaged in several industries, while new models are under development. I hope that in the coming years, they will appear on the market, and the doctors involved in this, will be able to use the new equipment, which will obviously be different for the better in terms of convenience.

Cryosurgery prospects now, from my point of view, interest in the field of neurosurgery. We have excellent scientists, neurosurgeons headed by Academician Krylov, his students work in RNCH, and perhaps we are the leaders in this field, namely in cryosurgery brain tumors - small, located deep in the central parts of the brain when perform operations very risky, but with the help 3mm cryoprobe is possible under ultrasound control after the craniotomy enter the cryoprobe in brain tumor and freeze under the control of the ultrasound tumor.

These results were presented at a conference in Japan. We went to Tokyo and caused great interest despite the fact that there cryosurgical Association arose much earlier than in Russia. Of great interest is probably due to the fact that, unfortunately, after Cooper in Europe and in the East, few people tried to brain cryosurgery. Now addicted operations "CyberKnife» (CyberKnife) - is also a method of treatment, the use of radiation exposure on the small structures in the brain. But this does not preclude the use of other methods that have just a local effect. And, as shown by the first results are very encouraging: the fast rehabilitation of patients, rapid functional recovery, early discharge of patients.

If we talk about the tumors at other sites, it is very interesting to use cryosurgery for tumors of the maxillofacial region, language, when it is necessary to perform, if possible, rather complex operation with Gone with the large number of tissues, then plastic surgery, there are cosmetic defects, disfiguring his face. Use in situations where it may be an alternative, the suppression of tumor growth by a low temperature is very promising. Furthermore, soft tissue and bone tumors, tumors of the liver and pancreas.

Perhaps a combination of cryotherapy with increasing temperature. That is, first frost, after the introduction of thugs RF probes and heating the tumor. It becomes much more accessible to the impact of heat already.

For tumors to rapidly dividing cells dangerous as cold and high temperatures.

It is shown that if the achieved temperature -70-50 degrees in the tumor long enough and keep for 5-10 minutes, then thawed again, slowly cooled, it is possible to completely destroy the tumor cells.

High temperatures, when the temperature is 100 degrees, causing boiling in the tissues, and now has equipment that allows you to control the temperature of the probe and to ensure that was just boiling temperature, not the temperature, when the tissues become non-conducting to electricity, because they simply lose water. And the combination of different methods of physical restraint in the future will allow us in those situations when a scalpel can not remove the tumor, with locally advanced tumors, to achieve good results in combination, undoubtedly with chemotherapy and radiotherapy.

Cryosurgery prospects are now in the sphere of interaction with other related areas not only cryo, but also the heating, ie it radiofrequency surgery; not only the local effects of cold and heat, but also systemic effects with chemotherapy; not only the use of chemotherapy and radiation exposure with radiation therapy. Thus, our knowledge about the possibilities of treatment of tumors expand and cryosurgical method is one such method that allows with minimal cost to achieve great effects in the future.