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1 Cryosurgery Mohadese hashemi Dr. Razjouyan 2008 2 Introduction Cryosurgery is a technique for freezing and killing abnormal cells. • is used to treat some kinds of cancer and some precancerous or noncancerous conditions • can be used both inside the body and on the skin. 3 4 What is cryosurgery? Cryosurgery (also called cryotherapy or cryoablation ) is the use of extreme cold produced by liquid nitrogen (or argon gas) to destroy abnormal tissue. 5 Brief history The first cryogens were liquid air and compressed carbon dioxide snow. Liquid nitrogen became available in the 1940s and currently is the most widely used cryogen. 6 Brief history this method is being supplanted by liquid nitrogen spray techniques is easy to use, and similar techniques can be employed to manage benign, premalignant, and malignant lesions. 7 Mechanism of Action liquid nitrogen or argon gas is circulated through a hollow instrument. The doctor uses ultrasound or MRI to guide the cryoprobe. A ball of ice crystals forms around the probe, freezing nearby cells. 8 GENERAL ADVANTAGE OF CRYOSURGERY • كاهش ميزان خون ريزي • تنظيم ميزان بافت نابود شده • كاهش درد 9 Cryosurgery is an alternative to SUEGERY for : • • • • • • • • • • Breast Prostate Early-stage skin cancers Precancerous conditions of the cervix liver cancer Colon Retinoblastoma tumors of the bone Parkinson ترميم سبكيه ي جدا شده و ترميم آب مرواريد 10 پاركينسون از اولين كاربرد هاي جراحي با سرما توقف لرزش با استفاده از انهدام بخشي از تاالموس براي اولين بار در دهه ي 60 ميالدي توسط اروين كوپلر انجام شد 11 prostate cancer can be used to treat men who have earlystage prostate cancer that is confined to the prostate gland. Long-term outcomes are not known is not used to treat prostate cancer that has spread outside the gland 12 prostate cancer 13 side effects These side effects may occur more often in men who have had radiation to the prostate : • lack of control over urine flow • Many men become important • In some cases, the surgery has caused injury to the rectum 14 primary liver cancer The tumor and a half inch margin of normal liver are frozen to -190°C for 15 minutes, which is lethal to all tissues. The area is thawed for 10 minutes and then re-frozen to -190°C for another 15 minutes. 15 Side effect Cryosurgery in the liver may cause damage to the bile ducts and/or major blood veseels, which can lead to hemorrhage (heavy bleeding) or infection. 16 skin cancer Cryosurgery has been used to treat skin lesions for approximately 100 years. Benign skin lesions that are suitable for freezing include actinic keratosis, solar lentigo, seborrheic keratosis, viral wart, molluscum contagiosum, and Dermatofibroma. 17 Advantages • Cryosurgery requires little time and fits easily into the physician's office schedule • low risk of infection • Short recovery times • Minimal wound care suture removal • cryosurgery requires no expensive supplies or injectable anesthesia. • treat AIDS-related Kaposi’s sarcoma when the skin lesions are small and localized 18 Disadvantage • Scarring • loss of sensation • loss of pigmentation • loss of hair in the treated area 19 New advantages • • • • • Simple pencil type grip for easy use . Very accurate application . Freezes to -89ºC and to a depth of 3mm . Interchangeable ‘contact’ heads for special applications including GUM, Podiatry & Dermatology . • Avoids all of the storage and transport problems associated with traditional cryotherapy 20 New advantages • Once a cylinder has been attached CryoAlfa can be kept in a drawer without degradation of the N20 contents for approximately 3 months . • Can be easily transported for use in home visits . • The level of cold generated can be adjusted by the rate at which the button is depressed. 21 Cervical cryosurgery • Cervical cryosurgery or cryotherapy is a gynecological treatment that freezes a section of the cervix. • Is also used for the treatment of cervicitis or inflammation of the cervix 22 Cervical cryosurgery • Cryosurgery is not a treatment for cervical cancer. 23 tumors of the bone • destruction of nearby bone tissue →fractures 24 25