Complications after cryosurgery with new miniature cryoprobes in long hollow bones: An animal trial

Popken, F.; Meschede, P.; Erberich, Heike; Koy, Timmo; Bosse, M.; Fischer, J. H.; Eysel, Peer

doi:10.1186/1471-2482-5-17

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…However the strength of the bone was weakened by the process of resorption, so fractures were common in this weight-bearing bone about three months after freezing. Popken et al used miniature cryoprobes cooled by liquid nitrogen to produce freezing in the tibia and femur of sheep [162,163]. The probe temperature was −180°C.…”

Section: Diverse Tissuementioning

confidence: 99%

Experimental cryosurgery investigations in vivo

2009

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Cryosurgery is the use of freezing temperatures to elicit an ablative response in a targeted tissue. This review provides a global overview of experimentation in vivo which has been the basis of advancement of this widely applied therapeutic option. The cellular and tissue-related events that underlie the mechanisms of destruction, including direct cell injury (cryolysis), vascular stasis, apoptosis and necrosis, are described and are related to the optimal methods of technique of freezing to achieve efficacious therapy. In vivo experiments with major organs, including wound healing, the putative immunological response following thawing, and the use of cryoadjunctive strategies to enhance cancer cell sensitivity to freezing, are described.

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Section: Diverse Tissuementioning

confidence: 99%

Experimental cryosurgery investigations in vivo

2009

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“…В настоящее время в клинической практике прямая инсталляция азота применяется редко, появились безопасные способы криовоздействия [21,22,23]. Использование современных малоинвазивных систем иногда позволяет отказаться от традиционных операций, минимизировать травматичность лечения [24,25]. Однако это не исключает холодового повреждения здоровой части кости.…”

Section: Discussionunclassified

Changes in the Structure and Mechanical Properties of the Bone after Puncture Cryoablation: Experimental Study

Beliaev

Prokhorov

Sushnikov

et al. 2019

Traumatology and Orthopedics of Russia

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Purpose of the study — to evaluate possible impact of cryoablation on a healthy bone and to identify probable causes of postoperative fractures.Materials and Methods. The authors performed cryoablation of the femur in the experiment on 8 mature rabbits of Soviet Chinchilla (SC) breed with a follow up for up to two months. Anitrogenous cryoprobe of 1.5 mm in diameter was introduced into the femur through a perforation hole. The bone was completely frozen up to -180°С in two cycles with continuous thermometry. Pathomorfological examinations were performed after 7 and 55 days along with assessment of bone hardness. Preparation of material stipulated sawing the bone at the fracture site along the bone axis. One half-bone was used for histological examination, and another one — for measuring mechanical properties by local pressing of a diamond indenter onto the bone at certain applied force. The distance between measurement points along the bone was 250 μm. Statistical processing included variance significance analysis using t-test.Results. The authors reported bone fractures at the site of cryodestruction in all animals in one week after the procedure. Statistical analysis of the measurements and histological examination demonstrated that freezing of the entire bone diameter up to -180°С results in its complete destruction. Strength reduction around the fracture site corresponded to the temperature distribution area in the range from -9ºС to -15ºС. However, areas of cooling below -40ºС exhibited some bone segments with normal hardness. Mosaic pattern of strength reduction is explained by microcirculation disorders. Histology confirmed thrombosis of intraosseous blood vessels in the area of cryotherapy. The first focal signs of osteomalacia emerged by the end of the first week after cryoablation. Subsequently, the bone preserved its regenerative properties, but by the end of the second month after the procedure the histogenesis was still not completed and the bone did not regain its strength.Conclusion. The authors believe that a limited number of cases, the specific features of the angioarchitecture of animal bones and their ability to produce a heavy periosteal response do not allow to apply obtained quantitative outcomes of the present study to clinical situations. However, complete freezing of the entire bone diameter inevitably results in fracture formation.

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“…Экспериментальные исследования, посвященные влиянию криогенной температуры на костную ткань, изначально имели ясную клиническую направленность. Первые работы были посвящены изучению гистологической перестройки остеоцитов в условиях низкой температуры [33,58], патоморфологии кости в зоне охлаждения [41,46], особенностям микроциркуляции [69] и регенерации [45,74], изменению прочности поврежденной кости [32,67], возможной комбинации криодеструкции с имплантацией костных трансплантатов [42], экспериментальной оценке эффективности новых видов криогенного оборудования для разрушения опухолей костей [66].…”

Section: обзор проблемыunclassified

“…Ситуация изменилась с появлением малоинвазивных криозондов -cначала на относительно маломощных аргон-гелиевых хладагентах [19], а затем -на жидком азоте [3]. Прикладные технические [3,30], экспериментальные [66], лабораторные [18] и клинические [22] исследования, разработка методов точной навигации инструментов [21,23] позволили достаточно быстро внедрить новую технологию в практику. Первый опыт использования чрескожной пункционной криоаблации позволил решить сложную проблему адекватного обезболивания пациентов с метастатическим поражением костей [26,31,37,47,82].…”

Section: обзор проблемыunclassified

Cryosurgery in the Treatment of Patients With Bone Tumors

Belyaev¹,

Prokhorov²,

Arkhitskaya³

2019

Problems in oncology

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A review of the literature shows that surgical procedures will remain the standard treatment for primary bone tumors. Analysis of studies on the assessment of long-term results shows that additional double cryogenic treatment of the curettage cavity can improve the treatment outcomes of patients with giant cell tumors, dysplastic diseases and some forms of malignant lesions. The traditional execution of the procedure is associated with the open installation of liquid nitrogen in the bone cavity, which requires special skills in handling aggressive refrigerant from the staff and does not exclude complications. In case of multiple metastatic bone lesions, surgical treatment is not indicated. The recent emergence in clinical practice of new equipment with a closed liquid nitrogen circulation circuit inside cryoprobes resumes interest in cryoabla-tion of bone tumor lesions using modern minimally invasive puncture cryotechnology and expanding indications for its use in patients with severe comorbidities.

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Complications after cryosurgery with new miniature cryoprobes in long hollow bones: An animal trial

Abstract: Background: In vitro studies show that new miniature cryoprobes are suitable for cryoablation of bone tissue. The aim of this animal trial on 24 sheep was to examine the perioperative complications, particularly the danger of embolism, of cryoablation when using miniature cryoprobes.

Cited by 5 publications

References 19 publications

Experimental cryosurgery investigations in vivo

Experimental cryosurgery investigations in vivo

Changes in the Structure and Mechanical Properties of the Bone after Puncture Cryoablation: Experimental Study

Cryosurgery in the Treatment of Patients With Bone Tumors

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