cryosurgery

Cryosurgery (cryotherapy) is the application of extreme cold to destroy abnormal or diseased tissue.^[1] The term comes from the Greek words cryo (κρύο) ("icy cold") and surgery (cheirourgiki - χειρουργική) meaning "hand work" or "handiwork". Cryosurgery has been historically used to treat a number of diseases and disorders, especially a variety of benign and malignant skin conditions.^[2]

Uses

Warts, moles, skin tags, solar keratoses, and small skin cancers are candidates for cryosurgical treatment. Several internal disorders are also treated with cryosurgery, including liver cancer, prostate cancer, lung cancer, oral cancers, cervical disorders and, more commonly in the past, hemorrhoids. Generally, all tumors that can be reached by the cryoprobes used during the operation are treatable. Although found to be effective, this method of treatment is only appropriate for use against localized disease, and solid tumors larger than 1 cm. Tiny, diffuse metastases that often coincide with cancers are usually not affected by cryotherapy.

Cryosurgery works by taking advantage of the destructive force of freezing temperatures on cells. At low temperatures, ice crystals form inside the cells, which can tear them apart. More damage occurs when blood vessels supplying the diseased tissue freeze.

Method

The most common method of freezing lesions is using liquid nitrogen as the cooling solution. The super-cooled liquid may be sprayed on the diseased tissue, circulated through a tube called a cryoprobe, or simply dabbed on with a cotton or foam swab. Less frequently, doctors use carbon dioxide "snow" formed into a cylinder or mixed with acetone to form a slush that is applied directly to the treated tissue. Recent advances in technology have allowed for the use of argon gas to drive ice formation using a principle known as the Joule-Thomson effect. This gives physicians excellent control of the ice, and minimizing complications using ultra-thin 17 gauge cryoneedles.

Cryosurgery is a minimally invasive procedure, and is often preferred to more traditional kinds of surgery because of its minimal pain, scarring, and cost; however, as with any medical treatment, there are risks involved, primarily that of damage to nearby healthy tissue. Damage to nerve tissue is of particular concern.

Patients undergoing cryosurgery usually experience minor-to-moderate localized pain and redness, which can be alleviated by oral administration of analgesics such as aspirin, ibuprofen or acetaminophen (paracetamol). Blisters may form, but these usually scab over and peel away within several days.

See also

• Cryotherapy
• Electrosurgery

References

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