Cryosurgery

Cryosurgery is a new technique that can destroy tumors in a variety of sites (brain, breast, kidney, prostate, liver). Cryosurgery is the destruction of abnormal tissue using sub-zero temperatures. The tumor is not removed and the destroyed cancer is left to be reabsorbed by the body. Initial results in properly selected patients with unresectable liver tumors are equivalent to those of resection.

Cryosurgery involves the placement of a stainless steel probe into the center of the tumor. Liquid nitrogen is circulated through the end of this device. A picture of the cryoprobe is shown.

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. After the tumor has thawed, the probe is removed, bleeding is controlled, and the procedure is complete. The patient will spend the first post-operative night in the intensive care unit and typically is discharged in 3 - 5 days.

Proper selection of patients and attention to detail in performing the cryosurgical procedure are mandatory in order to achieve good results and outcomes. Frequently, cryosurgery is used in conjunction with liver resection as some of the tumors are removed while others are treated with cryosurgery. Patients may also have insertion of a hepatic intra-arterial artery catheter for post-operative chemotherapy. As with liver resection, your surgeon should have experience with cryosurgical techniques in order to provide the best treatment possible.

Below is a picture of an iceball in a patient with a metastases from a colon cancer.

Following resection or cryosurgery, your physician may recommend chemotherapy. In my experience, patients who respond to chemotherapy and undergo surgical treatment of their liver tumors will achieve superior outcomes. Discuss the use of chemotherapy with your physician to determine if this will be of benefit for you in the treatment of your disease.

Your choice of surgeon is a critical part of your treatment plan. Choose a surgeon who is Board Certified and who has performed the specific operation many times. Choose a surgeon who is willing to answer your questions and provide as much information as you need. Your surgeon should be confident and able to reassure you that everything possible is being done to improve your condition.

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