Renal Cryotherapy in a Sheep Model; A Feasability Study

Cozzi, Paul; Lynch, William J.; Collins, Sean M.; Vonthethoff, Leon; Morris, David L.

doi:10.1016/s0022-5347(01)65255-8

Cited by 33 publications

(8 citation statements)

References 23 publications

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“…The shapely demarcated lesions showed a mild inflammatory response and late fibrous scar formation. The lethal tissue temperature for normal kidney cells has been reported to be about −20°C in single freeze-thaw cycles [29,41]. Wooley et al in experiments in dogs, noted the greater destruction produced by repeater freezing cycles [214].…”

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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“…Tamponade of the tract was generally all that was necessary for hemostasis. 28,34,35,39,41,43,44 In contrast, perhaps because of the small size of the cryoprobes used in our study, we did not encounter any bleeding in any of our animals.…”

mentioning

confidence: 69%

“…[38][39][40] Healing from cryoablation is gradual, occurring by secondary intention with steady fibrotic contracture of the involved area that produces a wedge-shaped chronic lesion. 28,38,41,42 At 1 week, we noted ischemic coagulative necrosis with a relatively abrupt (1-to 2-mm) transition from necrotic to viable tissue at the border of the lesion. There was hemorrhage in the transition zone.…”

Section: Figmentioning

confidence: 84%

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Needle-Based Ablation of Renal Parenchyma Using Microwave, Cryoablation, Impedance- and Temperature-Based Monopolar and Bipolar Radiofrequency, and Liquid and Gel Chemoablation: Laboratory Studies and Review of the Literature

Rehman

Landman

Lee

et al. 2004

Journal of Endourology

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"Needle-based ablation of renal parenchyma using microwave, cryoablation, impedance-and temperature-based monopolar and bipolar radiofrequency, and liquid and gel chemoablation: Laboratory studies and review of the literature." Journal of Endourology.18,1. 83-104. (2004 ABSTRACTBackground and Purpose: Small renal tumors are often serendipitously detected during the screening of patients for renal or other disease entities. Rather than perform a radical or partial nephrectomy for these diminutive lesions, several centers have begun to explore a variety of ablative energy sources that could be applied directly via a percutaneously placed needle-like probe. To evaluate the utility of such treatment for small renal tumors/masses, we compared the feasibility, regularity (consistency in size and shape), and reproducibility of necrosis produced in normal porcine kidneys by different modes of tissue ablation: microwaves, cold impedance-based and temperature-based radiofrequency (RF) energy (monopolar and bipolar), and chemical. Chemoablation was accomplished using ethanol gel, hypertonic saline gel, and acetic acid gel either alone or with simultaneous application of monopolar or bipolar RF energy. Materials and Methods: A total of 107 renal lesions were created laparoscopically in 33 domestic pigs. Microwave thermoablation (N 5 12) was done using a Targis T3 (Urologix) 10F antenna. Cryoablation (N 5 16) was done using a single 1.5-mm probe or three 17F microprobes (17F SeedNet™ system; Galil Medical) (N 5 10 single probe and N 5 6 three probes); a double freeze cycle with a passive thaw was employed under ultrasound guidance. Dry RF lesions were created using custom-made 18-gauge single-needle monopolar probe with two or three exposed metal tips (GelTx) (N 5 12) or a single-needle bipolar probe (N 5 6) at 50 W of 510 kHz RF energy for 5 minutes. In addition, a multitine RF probe (RITA Medical Systems) was used in one set of studies (N 5 6). Both impedance-and temperature-based RF were evaluated. Chemoablation was performed with 95% ethanol (4 mL), 24% hypertonic saline (4 mL), and 50% acetic acid (4 mL) as single injections. In addition, chemoablation was tested with monopolar and bipolar RF (wet RF). Tissues were harvested 1 week after ablation for light microscopy.Results: In 11 of the 15 ablation techniques, there was complete necrosis in all lesions; however, three ethanol gel lesions had skip areas, three hypertonic saline gel lesions showed no necrosis or injury, and one monopolar RF and one bipolar RF lesion showed skip areas. In contrast to impedance-based RF, heat-based RF (RITA) caused complete necrosis without skip areas. All cryolesions resulted in complete tissue necrosis, and cryotherapy was the only modality for which lesion size could be effectively monitored using ultrasound imaging.

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“…The purpose of the cryotherapy is not the excision of the tumor, but their necrosis “in situ.” The effects of renal cryoabation on the kidney have been studied in animal models [38]. …”

Section: Followup Cryosurgycal Ablation Of Srmmentioning

confidence: 99%

Radiologic Evaluation of Small Renal Masses (II): Posttreatment Management

Santos

Deltoro

Martin

et al. 2008

Advances in Urology

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The increase in the detection of small renal masses (SRMs) and their best knowledge leads to a change in the therapeutic management of these lesions. The use of a less aggressive surgical technique or even an expectant attitude is the current tendency, in order to preserve as much renal function as possible. Imaging techniques are essential in the followup of these lesions. It allows us to know the postsurgical changes and possible complications due to treatment and the presence of local recurrence and metastases. Furthermore, a close radiological followup of SRM related to ablative treatments is mandatory. The purpose of this article is to reveal the imaging features of complications due to surgical or ablative treatments, local recurrence and metastasis, as well as their followup.

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Renal Cryotherapy in a Sheep Model; A Feasability Study

Abstract: We conclude that renal cryotherapy is safe and can achieve effective renal necrosis in the sheep model.

Cited by 33 publications

References 23 publications

Experimental cryosurgery investigations in vivo

Experimental cryosurgery investigations in vivo

Needle-Based Ablation of Renal Parenchyma Using Microwave, Cryoablation, Impedance- and Temperature-Based Monopolar and Bipolar Radiofrequency, and Liquid and Gel Chemoablation: Laboratory Studies and Review of the Literature

Radiologic Evaluation of Small Renal Masses (II): Posttreatment Management

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