Cryosurgery updated

Abstract

Cryosurgery is an effective modality for treatment of many benign, premalignant, and malignant cutaneous lesions. New indications for benign lesions, new data, and recent trends towards more aggressive treatment of malignant lesions are mentioned. The differences in management between benign and malignant lesions are addressed. This article discusses cryobiology, equipment, advantages of cryosurgery, techniques of treatment, tissue response, results, complications, and contraindications.

Cryosurgery as an Effective Alternative for Treatment of Oral Lesions in Children

“…Since cryosurgery is a non-invasive therapy, it does not need local anesthesia, never has complications during the surgery procedures, and it may be used to treat multiple lesions at the same time. In addition, it is better tolerated by fearful children (20). This is a great advantage in Pediatric Dentistry.…”

“…The mechanisms of cell death following freezing have received considerable attention. Studies of isolated cells or tissues have defined ice-crystal dimensions and locations and have led to the commonly held view that intracellular ice is usually lethal, whereas extracellular ice is not (20).…”

Endotherapy for Barrett’s Esophagus: Which, How, When, and Who?

“…Sprayed liquid nitrogen is applied to the target area, and freeze-thaw cycles result in tissue destruction by intracellular disruption and tissue ischemia, with relative preservation of the extracellular matrix to promote less fibrosis formation. 56,57 Placement of an orogastric decompression tube allows for adequate excess nitrogen gas expulsion to help prevent inadvertent gastrointestinal viscus perforation. Repeat treatment sessions may be conducted every 4 to 6 weeks as needed to ensure complete remission of the target area's neoplasia.…”

Traitement endoscopique de l’œsophage de Barrett

“…Le cathéter est positionné en regard des lésions, sans contact avec la muqueuse et produit une congélation du tissu cible sur 2 mm de profondeur [58]. La cryothérapie crée des lésions biologiques par un refroidissement rapide entrainant une faillite du méta-bolisme cellulaire, une destruction des structures intracellulaires et une nécrose ischémique des tissus avec une préservation relative de la matrice extra-cellulaire qui pourrait atténuer le risque de fibrose secondaire [59,60]. Une mort retardée par apoptose des cellules à la périphérie de la lésion de cryothérapie a également été observée [58].…”