Effect of Freezing Parameters (Freeze Cycle and Thaw Process) on Tissue Destruction Following Renal Cryoablation

Woolley, Matthew L.; Schulsinger, David A.; Durand, D; Zeltser, Ilia S.; Waltzer, Wayne C.

doi:10.1089/089277902760367494

Cited by 113 publications

(54 citation statements)

References 12 publications

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“…The double freeze-thaw cycle has been shown to increase liquefaction necrosis and hence improve efficacy. 20,21 The interposed thawing causes cells to "burst" which is important to ensure cell death. [5][6][7][8][9][10][11]20,21 During the freezing cycle, limited CTs are obtained every 3 to 4 minutes to affirm coverage of the lesion by the iceball.…”

Section: Technique Of Cryoablationmentioning

confidence: 99%

“…20,21 The interposed thawing causes cells to "burst" which is important to ensure cell death. [5][6][7][8][9][10][11]20,21 During the freezing cycle, limited CTs are obtained every 3 to 4 minutes to affirm coverage of the lesion by the iceball. 5,7,8,12,14,20 To identify possible "skip zones," a contrast-enhanced CT was obtained after the second freeze cycle.…”

Section: Technique Of Cryoablationmentioning

confidence: 99%

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Efficacy of percutaneous cryoablation of renal cell carcinoma in older patients with medical comorbidities: Outcome study in 70 patients

Lang

Zhang

Nguyen

et al. 2015

CUAJ

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Introduction: The aim of this study was to establish the efficacy of cryoablation for incidentally discovered small renal cell carcinomas in older patients with medical comorbidities. Methods: We carried out a retrospective chart analysis of outcomes of 70 patients treated by cryoablation. The inclusion criteria were age >56 years, medical comorbidities (Charlson class I-III), and suitability for cryoablation established by urologists and interventional radiologists. In total, 43 patients were male, 27 female, and the age range was 56 to 89. The lesions measured 1.5 to 4 cm; 29 were high-grade Fuhrman and 41 were low grade. All lesions were treated by 2 10-minute freezing cycles separated by an 8-minute thawing period. One to seven cryoprobes were inserted according to a preoperative, 3D computed tomography (CT)-based plan. Results: Results were assessed on follow-up CTs (at 8-9 months). Of the 70 patients, 68 were treated by cryoablations and surgical salvage procedures; these patients were free of disease for 23 to 72 months (mean 39). One patient experienced recurrence and the other was lost to follow-up. One or two cryoablations rendered 66 patients tumour-free and additional surgery rendered another 2 patients tumour-free. The location and configuration of the lesion affected outcomes. Of the 27 posterior lesions, there was 1 failure; of the postero-lateral lesions, there were 4 failures; of the anterior lesions, there were 5 lesions; finally of the 32 central or deep seated lesions, there were 9 failures. Implants with one and two cryoprobes had a high recurrence rate. Three major complications were managed by minor interventions. The mean hospitalization was 1.3 days and the procedure times were variable. Conclusion: Percutaneous cryoablation is recommended as a minimally invasive nephron-sparing treatment for amenable lesions in older patients with medical comorbidities.

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Section: Technique Of Cryoablationmentioning

confidence: 99%

Section: Technique Of Cryoablationmentioning

confidence: 99%

Efficacy of percutaneous cryoablation of renal cell carcinoma in older patients with medical comorbidities: Outcome study in 70 patients

Lang

Zhang

Nguyen

et al. 2015

CUAJ

View full text Add to dashboard Cite

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“…Deneysel ve çok sayıda hastayı içeren klinik çalışmalarda, iki siklus uygu-lanan dondurma-eritme işleminde buz topu formasyonunun kitle sınırının 10-31 mm. ilerisine ulaştığı tespit edilmiş ve bu uygulamanın tek siklus uygulanan dondurma-eritme işlemine göre onkolojik açıdan klinikte daha başarılı sonuçlar verdiği rapor edilmiştir (14)(15)(16).…”

Section: Teknikunclassified

“…Bu işlem iki siklus şeklinde uygulanır. Bazı yayınlarda, pasif olarak yapılan eritme işleminin helyum gazı ile yapılan aktif ve hızlı eritme işlemine göre daha etkili olduğu bildirilmiştir (15,17). Son zamanlarda argon/helyum gaz sistemi sirkülas-yonuna sahip, probun ucunda oluşan Joule-Thomson etkisi ile lezyonu hızlıca donduran 3. kuşak kriyoteknoloji cihazların klinik pratiğe girmesi ve ultra ince 17-gauge iğnelerin kullanıma sunulması ile birlikte böbrek kapsülüne travma oluşturulmadan girilebilmekte ve ultrasonografi kılavuzlu-ğunda kriyoproblar ile kitlenin içerisine kesin doğrulukta ilerlenebilmektedir.…”

Section: Teknikunclassified

Küçük Böbrek Kitlelerinin Minimal İnvaziv Tedavisinde Kriyoablasyon mu, Radyofrekans Ablasyon mu?

Tuncel¹,

Senel²,

Aslan³

2015

Endouroloji

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“…It is therefore important to apply an ice ball at least 6-8 millimeters beyond the tumor margin (Desai and Gill, 2002). In addition, double freezing, when compared with a single-freeze approach, has been shown to produce a larger area of necrosis in an animal model (Woolley et al, 2002). As a consequence, the (sonographic) determination of the ice ball is an essential part of the procedure.…”

Section: Description Of the Cryoablation Techniquementioning

confidence: 99%

Standard of Care and New Operative Techniques for Small Renal Tumors: a Meta-analysis with a Special Focus on Cryoablation

Poder¹,

He²,

Lemieux³

2010

GJHS

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Introduction: the aim of this article is to realize a meta-analysis of published data evaluating open nephrectomy, laparoscopic nephrectomy and cryoablation for small renal masses to define the current data, and to adjust oncological results for patients and follow-up heterogeneity by performing econometric estimations.Materials and methods: a systematic literature review using the STROBE checklist was performed for clinically localized sporadic renal masses from the beginning of January 1996 until October 31, 2008. The main variables evaluated were patients' age and sex, tumor size, ASA score, duration of follow-up, available clinical outcomes, pathological data, and oncological outcomes.Results: 152 studies representing 19 994 patients were analyzed. The authors found a significant lower operation time for percutaneous cryoablation, and a lower hospital stay and blood losses for all types of cryoablation (i.e. open, laparoscopic and percutaneous). No significant difference is found between cryoablation and resection methods as regard to complication rates. When adjusting oncological results for patients and follow-up heterogeneity, higher recurrence rates at five years are found for cryoablation, on the contrary, no difference is found for specific-cancer survival rates at five years.Conclusions: cryoablation is a safe and less invasive procedure than resection methods. However, its long term efficacy has not yet been established and a more stringent selection of patients is needed to reduce recurrence rates.

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Effect of Freezing Parameters (Freeze Cycle and Thaw Process) on Tissue Destruction Following Renal Cryoablation

Cited by 113 publications

References 12 publications

Efficacy of percutaneous cryoablation of renal cell carcinoma in older patients with medical comorbidities: Outcome study in 70 patients

Efficacy of percutaneous cryoablation of renal cell carcinoma in older patients with medical comorbidities: Outcome study in 70 patients

Küçük Böbrek Kitlelerinin Minimal İnvaziv Tedavisinde Kriyoablasyon mu, Radyofrekans Ablasyon mu?

Standard of Care and New Operative Techniques for Small Renal Tumors: a Meta-analysis with a Special Focus on Cryoablation

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