- Статьи
- Science and technology
- Frost under the skin: Russia has come up with a painless cancer cryotherapy technique
Frost under the skin: Russia has come up with a painless cancer cryotherapy technique
Russian doctors have begun to apply an improved method of destroying cancerous kidney tumors using low temperatures. The use of computed tomography for more precise placement of cryopigles in the diseased tissue and smooth defrosting after the procedure made it possible to reduce the traumatic nature of treatment and use local anesthesia for this purpose. This has made kidney cryotherapy available to the most vulnerable patients who are contraindicated for surgery. According to experts, the innovations expand the possibilities of using the methodology. However, to improve the results, it is necessary to learn how to control the freezing area more precisely.
How did scientists achieve the precision of cryoinglution
Sechenov University specialists have proposed a new method of treating kidney tumors using low temperatures. They used CT scans to accurately insert cold-acting cryopigles into the diseased tissue, and then gradually defrosted the tumor using electricity. This approach reduced the risk of injury and made it possible to perform surgery under local anesthesia. Due to this, the intervention can be performed for patients who, due to their serious condition, cannot withstand anesthesia. And after the operation, the patient can be sent home after a few hours, although previously it took a longer time to recover.
— Previously, ultrasound was used for guidance, but we began to use computed tomography for this, which made it possible to increase the accuracy of the procedure. CT scans are used to insert special cryopigles into the tumor. CT allows you to clearly see the boundaries of the tumor and track the formation of an ice ball around it when the needle begins to conduct cold. If an ice ball covers the entire tumor according to CT scans, it means that all oncological canons were observed during the procedure," said Stanislav Ali, associate professor at the Institute of Urology and Human Reproductive Health at Sechenov University.
The cryoablation method is based on the effect of low temperature on tumor cells. It has been experimentally proven that they die at -40 ° C, but at -20 ° C the kidney tissue itself dies, so the accuracy of the procedure is very important. It is usually prescribed to patients with complications who cannot receive other types of treatment.
The updated cryoablation procedure was performed on a 69-year-old patient. He had a single right kidney, in the lower segment of which there is a tumor with a maximum size of 3.7 cm. A biopsy performed before the operation confirmed the cancer. The man's second kidney died. The patient was in serious condition, he had a history of two heart attacks, and stents were implanted in the coronary vessels. At the oncological council, it was decided to abandon robotic surgery in favor of cryoablation, as the patient may not be able to undergo anesthesia.
— Such tumors can be observed in dynamics, but according to the world literature, there is a risk of metastasis after detection in the first year — about 10-12%. Therefore, it was decided to perform cryoablation on him in a short time," Stanislav Ali clarified.
Cryoablation was performed using a special cryodestruction system. Urologists at Sechenov University used a new generation device that uses electric defrosting instead of helium to defrost an ice ball.
— To remove the cryopigles, the tissues need to be thawed. When they are thawed according to the principle of shock defrosting, the cell membrane is destroyed. To avoid this, the device has a delayed defrosting mechanism using electricity," explained Stanislav Ali.
According to clinical observations, the effectiveness of cryoablation is comparable in terms of positive oncological effect with robot-assisted operations. This is a modern method of surgical intervention in which the surgeon performs all procedures using special equipment. But when it is not possible to perform surgery on the patient, this technique has no alternative.
Is it possible to expand the capabilities of the new method
Of course, cryoablation is far from a new technique and has indeed been widely used in medicine for a long time. It has proven itself as a promising addition to surgical interventions, said the head of the Department of Biochemistry. Academician T.T. Berezova RUDN University Vadim Pokrovsky.
— Colleagues have made a number of technical improvements, while maintaining the basic principle of the method — the local destruction of tissues under the influence of extreme cold. Although the changes are not revolutionary, they significantly expand the possibilities of clinical application of the technique," said Vadim Pokrovsky.
Cryodistruction methods of tumors have been used since the 60s of the last century. But the problem with using them is that the freezing zone cannot be clearly controlled. CT scans can accurately understand the location of the tumor, but it is impossible to understand the temperature of the tissue and freeze it in exactly the right place, said oncologist Andrei Atroshenko.
— If the tumor is not frozen enough, then some of the cells will not die. It is unclear if they were able to solve this problem. That is, it is important to freeze in the correct volume. If you have learned how to do this, then the method is promising. In the meantime, this obstacle prevents the method from being widely used," said Andrei Atroshenko.
Cryoablation is one of the methods of local destruction of the tumor, which is suitable for use in certain cases. For example, for elderly patients who cannot undergo surgery. It is inevitable that a part of the healthy tissue is also damaged. It doesn't matter which method is used. The same thing happens during surgical resection, said Igor Samoylenko, head of the Department of Skin Tumors at the N.N. Blokhin National Research Medical Center of Oncology.
Переведено сервисом «Яндекс Переводчик»
