Cryosurgery
Encyclopedia
Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. The term comes from the Greek words cryo (κρύο) ("icy cold") and surgery (cheirourgiki - χειρουργική) meaning "hand work" or "handiwork".
Cryosurgery has been historically used to treat a number of diseases and disorders, especially a variety of benign and malignant skin conditions.
s, moles
, skin tags, solar keratoses, Morton's neuroma
and small skin cancer
s are candidates for cryosurgical treatment. Several internal disorders
are also treated with cryosurgery, including liver cancer
, prostate cancer
, lung cancer, oral cancers, cervical
disorders and, more commonly in the past, hemorrhoids. Soft tissue conditions such as plantar fasciitis
and fibroma
can be treated with cryosurgery.
Generally, all tumors that can be reached by the cryoprobes used during an operation are treatable. Although found to be effective, this method of treatment is only appropriate for use against localized disease, and solid tumors larger than 1 cm. Tiny, diffuse metastases that often coincide with cancers are usually not affected by cryotherapy.
Cryosurgery works by taking advantage of the destructive force of freezing temperatures on cells
. At low temperatures, ice crystals form inside the cells, which can tear them apart. More damage occurs when blood vessel
s supplying the diseased tissue freeze.
as the cooling solution. The super-cooled liquid may be sprayed on the diseased tissue, circulated through a tube called a cryoprobe, or simply dabbed on with a cotton or foam swab.
"snow" formed into a cylinder or mixed with acetone
to form a slush that is applied directly to the treated tissue.
gas to drive ice formation using a principle known as the Joule-Thomson effect
. This gives physicians excellent control of the ice, and minimizing complications using ultra-thin 17 gauge
cryoneedles.
and propane
is used in some preparations such as Dr. Scholl's
Freeze Away. The mixture is stored in an aerosol spray
type container at room temperature and drops to -41 C when dispensed. The mixture is often dispensed into a straw with a cotton-tipped swab.
is of particular concern.
Patients undergoing cryosurgery usually experience minor-to-moderate localized pain and redness, which can be alleviated by oral administration of analgesics such as aspirin
, ibuprofen
or acetaminophen (paracetamol). Blister
s may form, but these usually scab over and peel away within several days.
Cryosurgery has been historically used to treat a number of diseases and disorders, especially a variety of benign and malignant skin conditions.
Uses
WartWart
A wart is generally a small, rough growth, typically on a human’s hands or feet but often other locations, that can resemble a cauliflower or a solid blister. They are caused by a viral infection, specifically by human papillomavirus 2 and 7. There are as many as 10 varieties of warts, the most...
s, moles
Mole (skin marking)
A melanocytic nevus is a type of lesion that contains nevus cells .Some sources equate the term mole with "melanocytic nevus". Other sources reserve the term "mole" for other purposes....
, skin tags, solar keratoses, Morton's neuroma
Morton's neuroma
Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the third and fourth intermetatarsal spaces.This problem is characterised by pain and/or numbness, sometimes relieved by removing footwear.Despite the name, the...
and small skin cancer
Skin cancer
Skin neoplasms are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises...
s are candidates for cryosurgical treatment. Several internal disorders
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...
are also treated with cryosurgery, including liver cancer
Hepatocellular carcinoma
Hepatocellular carcinoma is the most common type of liver cancer. Most cases of HCC are secondary to either a viral hepatitide infection or cirrhosis .Compared to other cancers, HCC is quite a rare tumor in the United States...
, prostate cancer
Prostate cancer
Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly...
, lung cancer, oral cancers, cervical
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
disorders and, more commonly in the past, hemorrhoids. Soft tissue conditions such as plantar fasciitis
Plantar fasciitis
Plantar fasciitis is a painful inflammatory process of the plantar fascia, the connective tissue on the sole of the foot.Longstanding cases of plantar fasciitis often demonstrate more degenerative changes than inflammatory changes, in which case they are termed plantar fasciosis. The suffix...
and fibroma
Fibroma
Fibromas are benign tumors that are composed of fibrous or connective tissue. They can grow in all organs, arising from mesenchyme tissue. The term "fibroblastic" or "fibromatous" is used to describe tumors of the fibrous connective tissue...
can be treated with cryosurgery.
Generally, all tumors that can be reached by the cryoprobes used during an operation are treatable. Although found to be effective, this method of treatment is only appropriate for use against localized disease, and solid tumors larger than 1 cm. Tiny, diffuse metastases that often coincide with cancers are usually not affected by cryotherapy.
Cryosurgery works by taking advantage of the destructive force of freezing temperatures on cells
Cell (biology)
The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....
. At low temperatures, ice crystals form inside the cells, which can tear them apart. More damage occurs when blood vessel
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...
s supplying the diseased tissue freeze.
Liquid nitrogen
A common method of freezing lesions is using liquid nitrogenLiquid nitrogen
Liquid nitrogen is nitrogen in a liquid state at a very low temperature. It is produced industrially by fractional distillation of liquid air. Liquid nitrogen is a colourless clear liquid with density of 0.807 g/mL at its boiling point and a dielectric constant of 1.4...
as the cooling solution. The super-cooled liquid may be sprayed on the diseased tissue, circulated through a tube called a cryoprobe, or simply dabbed on with a cotton or foam swab.
Carbon dioxide
Less frequently, doctors use carbon dioxideCarbon dioxide
Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...
"snow" formed into a cylinder or mixed with acetone
Acetone
Acetone is the organic compound with the formula 2CO, a colorless, mobile, flammable liquid, the simplest example of the ketones.Acetone is miscible with water and serves as an important solvent in its own right, typically as the solvent of choice for cleaning purposes in the laboratory...
to form a slush that is applied directly to the treated tissue.
Argon
Recent advances in technology have allowed for the use of argonArgon
Argon is a chemical element represented by the symbol Ar. Argon has atomic number 18 and is the third element in group 18 of the periodic table . Argon is the third most common gas in the Earth's atmosphere, at 0.93%, making it more common than carbon dioxide...
gas to drive ice formation using a principle known as the Joule-Thomson effect
Joule-Thomson effect
In thermodynamics, the Joule–Thomson effect or Joule–Kelvin effect or Kelvin–Joule effect describes the temperature change of a gas or liquid when it is forced through a valve or porous plug while kept insulated so that no heat is exchanged with the environment. This procedure is called a...
. This gives physicians excellent control of the ice, and minimizing complications using ultra-thin 17 gauge
Stubs Iron Wire Gauge
The Stubs Iron Wire Gauge system is used to specify thickness or diameter of metal wire, strip, and tube products...
cryoneedles.
Dimethyl ether - propane
A mixture of dimethyl etherDimethyl ether
Dimethyl ether , also known as methoxymethane, is the organic compound with the formula . The simplest ether, it is a colourless gas that is a useful precursor to other organic compounds and an aerosol propellant. When combusted, DME produces minimal soot and CO, though HC and NOx formation is...
and propane
Propane
Propane is a three-carbon alkane with the molecular formula , normally a gas, but compressible to a transportable liquid. A by-product of natural gas processing and petroleum refining, it is commonly used as a fuel for engines, oxy-gas torches, barbecues, portable stoves, and residential central...
is used in some preparations such as Dr. Scholl's
Dr. Scholl's
William Mathias Scholl was a podiatrist, pioneer of foot care and the founder of Dr. Scholl's, a brand of foot care products. Scholl went on to found the Illinois College of Chiropody and Orthopaedics. William M...
Freeze Away. The mixture is stored in an aerosol spray
Aerosol spray
Aerosol spray is a type of dispensing system which creates an aerosol mist of liquid particles. This is used with a can or bottle that contains a liquid under pressure. When the container's valve is opened, the liquid is forced out of a small hole and emerges as an aerosol or mist...
type container at room temperature and drops to -41 C when dispensed. The mixture is often dispensed into a straw with a cotton-tipped swab.
Results
Cryosurgery is a minimally invasive procedure, and is often preferred to more traditional kinds of surgery because of its minimal pain, scarring, and cost; however, as with any medical treatment, there are risks involved, primarily that of damage to nearby healthy tissue. Damage to nerve tissueNerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
is of particular concern.
Patients undergoing cryosurgery usually experience minor-to-moderate localized pain and redness, which can be alleviated by oral administration of analgesics such as aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
, ibuprofen
Ibuprofen
Ibuprofen is a nonsteroidal anti-inflammatory drug used for relief of symptoms of arthritis, fever, as an analgesic , especially where there is an inflammatory component, and dysmenorrhea....
or acetaminophen (paracetamol). Blister
Blister
A blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing , burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid called serum or plasma...
s may form, but these usually scab over and peel away within several days.