History of cryosurgery

Gage, Andrew A.

doi:10.1002/(sici)1098-2388(199803)14:2<99::aid-ssu2>3.0.co;2-1

Cited by 161 publications

(65 citation statements)

References 113 publications

(80 reference statements)

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“…Since then, advancements in cryosurgical technology have allowed for the use of much colder temperatures (as cold as −196°C) for tissue ablation. In addition, the development of technology that uses nitrous oxide or carbon dioxide as a cryogen (a substance used to produce very low temperatures) [2] has enabled reversible destruction of nerves, also known as cryoneurolysis. These technologies employ an established mechanism of action and have been used commercially since the early 1960s [3].…”

Section: Introductionmentioning

confidence: 99%

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

Ilfeld

Preciado

Trescot

2016

Expert Review of Medical Devices

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Introduction: Cryoneurolysis is the direct application of low temperatures to reversibly ablate peripheral nerves to provide pain relief. Recent development of a handheld cryoneurolysis device with small gauge probes and an integrated skin warmer broadens the clinical applications to include treatment of superficial nerves, further enabling treatments for pre-operative pain, post-surgical pain, chronic pain, and muscle movement disorders. Areas covered: Cryoneurolysis is the direct application of cold temperatures to a peripheral nerve, resulting in reversible ablation due to Wallerian degeneration and nerve regeneration. Use over the last 50 years attests to a very low incidence of complications and adverse effects. Cryoprobes have traditionally been applied through a surgical incision; but, recent technical advances allow percutaneous administration. A new hand-held device is now approved for use within the United States. Cryoneurolysis has been used to treat postoperative and chronic pain states as well as spasticity. Expert commentary: Changes in the US healthcare system such as a push for the reduction of opioid use and the incorporation of Diagnostic Related Group codes, as well as recent technological advances including a handheld unit that allows for treatment of superficial nerves while protecting the skin from damage, may contribute to the resurgence of cryoneurolysis for the treatment of peripheral nerves. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

Ilfeld

Preciado

Trescot

2016

Expert Review of Medical Devices

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“…Further, unlike other treatment strategies, molecular drug resistance can be overcome with thermal injury [10]. Although cryoablation is not a mainstream thermal technique for PaCa, it is a primary treatment option in other cancers [6,[16][17][18][19][20][21][22]. In 2008, the American Urological Association published a best practice statement on prostate cancer, recommending cryosurgery as a primary treatment option [23].…”

Section: Introductionmentioning

confidence: 99%

Dual thermal ablation of pancreatic cancer cells as an improved combinatorial treatment strategy

Baumann¹,

Baust²,

Snyder³

et al. 2017

Liver Pancreat Sci

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Pancreatic cancer (PaCa) is one of the leading causes of cancer related deaths in the world today. It is estimated that 95% of patients diagnosed with PaCa will die because of limited treatment options. As standard treatments have not yielded an improvement in patient outcome, alternative approaches, such as thermal ablation, may offer a new treatment path. We previously reported the lethal temperatures necessary for PaCa ablation for both freeze and heat based treatments. In this study, we investigated the response of PaCa cells in vitro to a combination treatment of heating and freezing, dual thermal ablation (DTA), in an effort to further improve ablation efficacy.PaCa cell lines, PANC-1 and BxPC-3, were subjected to heating (45 to 50°C), freezing (-10 to -20°C), or DTA exposure. Post-exposure viability was assessed over a 7-day recovery interval. Modes of cell death were analyzed using fluorescence microscopy and flow cytometry.Our results indicated that in comparison to single thermal modalities, DTA resulted in greater cell destruction at a more rapid rate. Specifically, -15°C had a moderate impact on day one cell viability (PANC-1=80%; BxPC-3=21%) and 50°C (PANC-1=74%; BxPC-3=18%) caused a slow decline in cell number post-treatment. The combination of these treatments resulted in an increased cell death one-day post-treatment (PANC-1=28%; BxPC-3=5%) and achieved complete cell destruction within three days. Overall, these data suggest that a combination of heat and freeze ablation, DTA, may provide for an improved treatment strategy for PaCa.

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“…19 As early as 1851, Archibald Arnott, a surgeon in the service of the East Indian Trade Company, described the use of ice-cold salt solution and crushed ice at temperatures ranging from Ϫ18°C to Ϫ24°C as an adjuvant treatment for advanced-stage breast or cervical carcinoma. 19 Since then, this concept has been applied to soft tissue and parenchymatous tumors in the liver, prostate, skin, breast, and cervix.…”

Section: Discussionmentioning

confidence: 99%

Role of adjuvant cryosurgery in intralesional treatment of sacral tumors

Kollender

Meller

Bickels

et al. 2003

Cancer

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BACKGROUNDCryosurgery is an adjuvant surgical technique for the treatment of benign aggressive, low‐grade malignant and metastatic tumors of long bones. It has been used rarely to treat sacral tumors, mainly because of potential damage to nerves, blood vessels, and intrapelvic organs. The authors described their experience with this procedure and provided medium and long‐term follow‐up results.METHODSFifteen procedures of cryosurgery of the sacrum were performed in 14 patients to improve the therapeutic outcome of a variety of tumors. The patient group included 7 males and 7 females with a mean age of 42 ± 24 years. Three patients were younger than 20 years of age. The procedures were performed at the Tel Aviv Sourasky Medical Center between January 1991 and January 1999. There were seven benign aggressive lesions (four giant cell tumors and three aneurysmal bone cysts), one benign schwannoma, one low‐grade chondrosarcoma, five metastatic carcinomas, and one high‐grade Ewing sarcoma, all localized at level S2 or higher. Eight of the bone tumors also involved significant anterior or posterior soft tissue. All patients had severe preoperative pain radiating to the buttocks, perineum, and lower limbs and 9 (64%) patients had bladder and/or rectal dysfunction. Invasive diagnostic procedures and radiation (if warranted) preceded surgery. Sacral posterior fenestration and burr drilling were followed by two‐cycle cryosurgery using the open pour technique or the argon‐helium–based heat‐freeze system.RESULTSAll interventions were performed under combined general and regional anesthesia and concluded uneventfully with moderate blood loss. Thirteen patients were discharged home after 8 ± 5 days (one patient remained hospitalized for 30 days). Only two patients experienced local disease recurrence during a 3–11‐year follow‐up period: one was retreated successfully by cryosurgery and the other underwent sacrectomy and radiotherapy elsewhere, with a subsequent loss of visceral functions. No patient suffered chronic pain, deep wound infections, or significant neurologic deficits and all were satisfied with the esthetic outcome.CONCLUSIONSCryosurgery is a conservative, feasible, and safe adjuvant technique in the treatment of sacral tumors. It is associated with minimal permanent neurologic and vascular injury compared with sacrectomy. Cancer 2003;97:2830–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11383

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History of cryosurgery

Cited by 161 publications

References 113 publications

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

Dual thermal ablation of pancreatic cancer cells as an improved combinatorial treatment strategy

Role of adjuvant cryosurgery in intralesional treatment of sacral tumors

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