Cryosurgery in the management of rectal tumours

Abstract

Ten patients with rectal tumours were treated by cryosurgery. Good palliation without local complications was achieved in the cases of rectal carcinoma and a complete cure followed treatment of benign rectal tumours. Low rectal carcinomas with clinical evidence of dissemination are ideally suited for cryosurgery and complications are minimal. Cryosurgery is a simple, safe procedure which can be performed without a general anaesthetic, and this study indicates that it has a place in the management of rectal tumours.

Palliation of carcinoma of the rectum using the urologic resectoscope

“…Fulguration may only be used for low rectal lesions [6]. Similarly, cryotherapy is only applicable for very low tumors [22]. Palliation by neodymium:yttrium-aluminium-garnet (Nd:YAG) laser through a flexible scope has been achieved and can be applied using minimal analgesia [21] in patients with tumors located up to 30 cm from the anal verge [29].…”

“…Nevertheless, not all patients will tolerate major palliative resectional surgery. Consequently, techniques such as electrocoagulation [10], cryotherapy [22], radiotherapy [14], endoscopic laser [10], and endoscopic transanal resection (ETAR) [2,23,30,33] have been used as alternatives to surgical treatment. ETAR, first described by Zinkin et al [33] in 1979, provides local control of the tumor and excellent palliation of symptoms, together with low morbidity and mortality [2,8,23,30,31,33].…”

Endoscopic trans-anal resection for palliation of acutely obstructed rectal cancer in frail elderly patients

“…Besides, fulguration may only be used for low rectal lesions [22]. Similarly, cryotherapy is only applicable for very low tumours [7]. 16 Palliation by neodymium: yttrium-aluminum-garnet (Nd:YAG) laser through a flexible scope has been achieved and can be applied using minimal analgesia [16] in patients with tumour located up to 30 cm from the anal verge [14].…”

“…In the particular case of obstructive rectal cancer, these have been treated by diverting loop colostomy but patients must accept the inconvenience of a stoma for what is left of their lives. Alternative techniques such as electro-coagulation [4][5][6], cryotherapy [7], radiotherapy [8], endoscopic laser [9][10][11][12][13][14][15][16] and endoscopic transanal resection (ETAR) [17][18][19][20] have been described.…”

Cryosurgery in the treatment of rectal carcinoma

“…Cryosurgery has also been used with good results (Langer, 1974). Osborne, Higgins and Hobbs (1978) report good palliation in 6 cases of rectal carcinoma, although no indication as to the nature, size and extent of dimensions is given. Two of their cases were complicated by the development of rectal stricture and one by the development of reactionary haemorrhage.…”