February 1997 Cryosurgical Publications
A weekly updated compilation of cryosurgery related publications
| Feb. 4th | Feb. 11th | Feb. 18th | Feb. 25th |
| BIOSYS |  | | | |
| MEDLINE | | | | |
BIOSYS Database:
1. Cespedes, R D; Pisters, L L; Von Eschenbach, A C; McGuire, E J.
Long-term followup of incontinence and obstruction after salvage
cryosurgical ablation of the prostate: Results in 143 patients.
Journal of Urology, v.157, n.1, (1997): 237-240.
Abstract:
Purpose: We report long-term followup of patients with incontinence and
obstruction after salvage cryosurgical ablation of the prostate. Materials
and Methods: We reviewed the records of 143 patients who underwent
cryosurgical ablation of the prostate for treatment failure after
radiation therapy. Data were collected by telephone interview with each
patient and chart review. Median followup was 27 months (range 12 to 42).
Results: Of 107 patients who underwent cryosurgical ablation of the
prostate using a commercially available urethral warmer 15 (14%) had
significant obstruction or retention that required transurethral resection
of the prostate in 10, of whom 6 became incontinent. Urinary incontinence
occurred in 45 patients (42%) and resolved in 21 (47%), for an overall 28%
long-term incontinence rate. Of 28 patients who underwent cryosurgical
ablation of the prostate using an alternative urethral warmer 13 (46%) had
incontinence and 15 (54%) had significant obstruction or retention.
Resolution was rare and 89% of the patients are currently incontinent.
Eight patients underwent 2 separate cryosurgical ablations with an 88%
incontinence rate (43% overall). The double freezing technique did not
increase postoperative obstruction or incontinence. Conclusions:
Incontinence and urinary retention rates are increased in patients
undergoing cryosurgical ablation of the prostate after failure of
radiation therapy but spontaneous resolution occurs in half of the
patients within 1 year if an effective urethral warmer is used.
Incontinence treatments should be delayed until after this period.
Postoperative incontinence and obstruction rates are significantly greater
when an effective urethral warmer is not used and spontaneous resolution
is rare.
MedLine Database:
1. Patel BG; Parsons CL; Bidair M; Schmidt JD.
Cryoablation for carcinoma of the prostate.
Journal of Surgical Oncology, 1996 Dec, 63(4):256-64.
Pub type: Journal Article; Review; Review, Tutorial.
(UI: 97136994)
Abstract: Percutaneous transperineal cryoablation of the prostate is now
available in the armamentarium for treatment of prostate cancer. Technical
advances in real-time transrectal imaging of the prostate and improvements
in cryosurgical equipment have brought this modality into the limelight of
available prostate cancer management. Cryosurgery can be offered to many
patients with prostate cancer. However, the main indications for its use
include primary treatment for localized disease, salvage therapy after
failure of traditional methods, and relief of local symptoms. A historical
background, description of the technique, and clinical experience at
several medical centers including the University of California San Diego,
Allegheny General Hospital, University of Texas M.D. Anderson Cancer
Center, and Crittenton Hospital, are presented.
2. Simo R; Sharma VL.
Treatment of rhinophyma with carbon dioxide laser.
Journal of Laryngology and Otology, 1996 Sep, 110(9):841-6.
(UI: 97106545)
Abstract: Rhinophyma is a slowly progressive, disfiguring disorder of the nose
which represents the end stage of acne rosacea. The cosmetic deformity is
often the reason for patients to seek medical attention. Over the years
many treatment modalities, including dermabrasion, electrocautery, excision
and grafting, decortication and cryosurgery amongst others, have been
described to treat this condition, but none of them are very satisfactory.
Special concern about the droplet dispersion of blood in dermabrasion have
made this method less acceptable as it poses a potential risk to health
workers. We describe a technique in which this proliferative disorder can
be treated, using carbon dioxide laser excision and vaporization. This
method provides a very dry surgical field which allows the sculpting of the
hypertrophic areas to be very effective, giving a very satisfactory
cosmetic result.
3. Rasmussen I; Garden OJ.
The management of liver cell cancer.
European Journal of Gastroenterology and Hepatology, 1996 Sep, 8(9):861-7.
Pub type: Journal Article; Review; Review, Tutorial.
(UI: 97044380)
Abstract: Hepatocellular carcinoma (HCC) is a highly malignant tumour. It
presents a considerable management problem. In this review the natural
history of HCC is summarized. Surgical and non-surgical treatment
modalities are reviewed. Finally, combined treatments are described.
4. Dithmar S; Tetz MR; Volcker HE.
[Fuchs' heterochromic cyclitis. Clinico-histopathologic findings of
nodular iritis].
Klinische Monatsblatter fur Augenheilkunde, 1996 Aug-Sep, 209(2-3):158-62.
Language: German.
(UI: 97053905)
Abstract: BACKGROUND: Despite the fact that in 1906 Fuchs described the first
case of Fuchs' heterochromic cyclitis histopathologic reports of this
disease are still rare. PATIENT AND METHODS: A clinicopathologic
correlation of findings in Fuchs' heterochromic cyclitis is presented. In a
patient with a history of Fuchs' heterochromic cyclitis for 15 years a
secondary open-angle glaucoma developed. Several operations were performed
including intracapsular cataract extraction, goniotrephanation (Elliot) and
repeated cyclocryotherapy. The eye finally had to be enucleated because of
a painful absolute glaucoma. RESULTS: Clinical hallmarks of Fuchs'
heterochromic cyclitis in this patient include cataract formation and
secondary open-angle glaucoma. Histology revealed accumulations of
mononuclear cells on the surface of the iris and the corneal endothelium,
as well as sparse inflammatory cells within the anterior chamber. The
trabecular meshwork showed an infiltration of mononuclear inflammatory
cells, chiefly lymphocytes and plasma cells. DISCUSSION: Accumulations of
mononuclear cells on the surface of the iris, which histopathologically
have not been described before, could represent the clinicopathologic
correlate of Koeppe and Busacca nodules. Histologically, the cell deposits
on the iris were similar to those in the anterior chamber and to larger
corneal precipitates. It is supposed that the cells, which originally
emigrated from the iris vessels, may form primary cell deposits on the iris
surface or endothelium. Such iris precipitates may also be secondarily
attracted by the endothelium in whole. An autoimmune-reaction against the
corneal endothelium may be the underlying reason.
5. Shalimov SA; Litvinenko AA; Zharkov IaV.
[Concept of producing highly-effective universal cryosurgery equipment].
Klinicheskaia Khirurgiia, 1996(5):50-2.
Language: Russian.
(UI: 97065464)
6. Litvinenko AA.
[Changes in the pancreatic parenchyma under the effects of different
methods of cryodestruction].
Klinicheskaia Khirurgiia, 1996(5):41-3.
Language: Russian.
(UI: 97065461)
7. Eliel M.
[Palliative cryosurgery in rectum carcinoma (letter)].
Nederlands Tijdschrift voor Geneeskunde, 1996 Nov 23, 140(47):2360.
Language: Dutch.
Pub type: Letter.
(UI: 97117774)
8. Vozmediano JM; Manrique A; Petraglia S; Romero MA; Nieto I.
Giant molluscum contagiosum in AIDS.
International Journal of Dermatology, 1996 Jan, 35(1):45-7.
(UI: 96436044)
Abstract: A 31-year-old man, an intravenous drug user and in an advanced stage
of acquired immune deficiency syndrome (AIDS), was admitted in our
Department for the treatment of skin lesions that had been diagnosed as
molluscum contagiosum (MC). The clinical examination revealed the presence
of multiple nodular lesions, some of which were notably large and whose
color resembled that of normal skin. These lesions were localized mainly to
the face, and in particular on the forehead, glabellar, malar, beard,
submandibular, and neck regions (Fig. 1). Smaller, crateriform lesions were
detected on the hands and the upper limbs. The lymphocyte subsets ratio was
0.02, with a CD4+ T cell count of 13 cells per mm3 (1%) and a CD8+ T cell
count of 624 per mm3 (48%). The patient also had leukopenia (1690 WBC per
mm3), moderate macrocytic anemia, elevation of transaminases (SGOT 105 U/L,
SGPT 114 U/L) and of immunoglobulins (IgG 2660 mg/dL), and a decrease of C3
(44.2 mg/dL) and C4 (16.6 mg/dL). Histologic examination revealed the
presence of typical MC lesions. In addition to an important acanthosis, it
was possible to detect pyriform lobules of perfectly delineated epidermal
cells, radially separated by fibrous septa that merge towards the central
crater. The characteristic MC eosinophil bodies were observed in infected
cells (Fig. 2). The lesions were treated with cryosurgery by spray. Many
courses of therapy were given with intervals of 2-3 weeks. Every session
consisted of two cycles of rapid freezing followed by a slow thaw. Many
lesions disappeared with this treatment, and others were reduced in size,
but total destruction of all lesions was not achieved (Fig. 3).
9. Gautier-Benoit C; Dequiedt B.
[Has amputation of the rectum by pure perineal approach or Lisfranc
operation still a role in the treatment of rectal cancer?].
Chirurgie, 1996, 121(3):193-6; discussion 196-7.
Language: French.
(UI: 97101299)
Abstract: Amputation of the rectum by a purely perineal route, the Lisfranc
procedure, has been progressively replaced by abdominoperineal methods. In
the AFC survey made in 1987, a Lisfranc was used only 26 times in 5,274
patients in the survey. We performed a Lisfranc 8 times from 1980 to 1993
in patients over 80 years of age or with an ASA score equal to or above 3.
There was one death due to multiple-organ failure 70 days after the
operation. Overall mean survival was 17.8 months and reached 24 months for
those who did not have metastasis as the time of the amputation. Quality of
life was assessed as good. Two patients had a local recurrence 1 and 3
years after the operation. We thus suggest that amputation of the rectum
using the Lisfranc procedure can be used for certain patients in which
simple colostomy (with no effect on the rectal syndrome), radiotherapy
(variable and limited response), chemotherapy and other palliative
procedures (electro-coagulation, laser cryosurgery) would not be indicated.
Whenever tumour exeresis appears to be possible, we suggest that this
method is the best palliative procedure to propose in elderly patients with
several organic disorders and for cancers of the lower third of the rectum.
The procedure should not however be attempted in patients with advanced
stage cancer and a survival time estimated at less than 6 months.
10. Leow CK; Lau WY; Li AK.
Cryoablation of unresectable malignant liver tumors [letter].
American Journal of Surgery, 1996 Nov, 172(5):607.
Pub type: Letter.
(UI: 97098031)
BIOSYS Database:
1. Connolly, J A; Shinohara, K; Presti, J C Jr; Carroll, P R.
Should cryosurgery be considered a therapeutic option in localized
prostate cancer?
Urologic Clinics of North America, v.23, n.4, (1996): 623-631.
MedLine Database:
MedLine Database:
1. Moul JW.
Radical prostatectomy and cryotherapy--some answers, more questions
[editorial; comment].
Journal of Urology, 1997 Jan, 157(1):256-7.
Pub type: Comment; Editorial.
(UI: 97130502)
2. Cespedes RD; Pisters LL; von Eschenbach AC; McGuire EJ.
Long-term followup of incontinence and obstruction after salvage
cryosurgical ablation of the prostate: results in 143 patients [see
comments].
Journal of Urology, 1997 Jan, 157(1):237-40.
(UI: 97130498)
Abstract: PURPOSE: We report long-term followup of patients with incontinence
and obstruction after salvage cryosurgical ablation of the prostate.
MATERIALS AND METHODS: We reviewed the records of 143 patients who
underwent cryosurgical ablation of the prostate for treatment failure after
radiation therapy. Data were collected by telephone interview with each
patient and chart review. Median followup was 27 months (range 12 to 42).
RESULTS: Of 107 patients who underwent cryosurgical ablation of the
prostate using a commercially available urethral warmer 15 (14%) had
significant obstruction or retention that required transurethral resection
of the prostate in 10, of whom 6 became incontinent. Urinary incontinence
occurred in 45 patients (42%) and resolved in 21 (47%), for an overall 28%
long-term incontinence rate. Of 28 patients who underwent cryosurgical
ablation of the prostate using an alternative urethral warmer 13 (46%) had
incontinence and 15 (54%) had significant obstruction or retention.
Resolution was rare and 89% of the patients are currently incontinent.
Eight patients underwent 2 separate cryosurgical ablations with an 88%
incontinence rate (43% overall). The double freezing technique did not
increase postoperative obstruction or incontinence. CONCLUSIONS:
Incontinence and urinary retention rates are increased in patients
undergoing cryosurgical ablation of the prostate after failure of radiation
therapy but spontaneous resolution occurs in half of the patients within 1
year if an effective urethral warmer is used. Incontinence treatments
should be delayed until after this period. Postoperative incontinence and
obstruction rates are significantly greater when an effective urethral
warmer is not used and spontaneous resolution is rare.
3. Rodriguez-Bigas MA; Klippenstein D; Meropol NJ; Weber TK; Petrelli NJ.
A pilot study of cryochemotherapy for hepatic metastases from colorectal
cancer.
Cryobiology, 1996 Dec, 33(6):600-6.
(UI: 97130894)
Abstract: Cryosurgery of hepatic metastases from colorectal carcinoma is a form
of local therapy for unresectable disease. After curative resection,
failures occur in the liver, and at extrahepatic sites. This pilot study
evaluated the toxicity and tolerance to cryotherapy and intraoperative
chemotherapy for unresectable hepatic metastases from colorectal cancer. If
after exploratory celiotomy for potential curative resection of hepatic
metastases the patient was deemed unresectable because of location and/or
number of lesions, cryosurgery and intraoperative chemotherapy with
systemic 5-fluorouracil 600 mg/m2 and leucovorin 500 mg/m2 was performed.
Four patients were treated with cryochemotherapy. All patients developed
toxicity. Two patients developed grade II leukopenia on Postoperative Days
2 and 12, and grades II and III diarrhea on Postoperative Days 5 and 7,
respectively. Grade III hyperbilirubinemia and thrombocytopenia occurred in
one patient on Postoperative Days 3 and 7. Acute respiratory distress
syndrome, postoperative ileus, and grade II mucositis occurred in one
patient each. All patients had delays and dose reductions on their
subsequent chemotherapy treatments secondary to toxicity. Two patients had
disease progression, one had stable disease. and one is "disease free."
Combining the tumoricidal effects of chemotherapy and cryosurgery is in
theory a good concept. However, the toxicity of 5-FU and leucovorin is
enhanced by this approach.
4. Karel I.
[Vitreous surgery in complicated retinal detachment].
Ceska a Slovenska Oftalmologie, 1996 Nov, 52 Suppl:26-33.
Language: Czech.
(UI: 97103906)
Abstract: Vitreous surgery in complicated retinal detachment has three main
objectives: 1. elimination of traction and mobilization of the retina, 2.
inner tamponade of the retina, 3. retinopexy. Pars plana vitrectomy with
inner tamponade is indicated: 1. In rhegmatogenous retinal detachment,
where vitreous hemorrhage or exsudate make the finding and localization of
the retinal break impossible. 2. In rhegmatogenous retinal detachments,
where the localization of the break in the posterior eye pole or the size
of a giant tear prevent to close the retinal break by means of a
cryosurgical procedure with episcleral plombage. 3. In retinal detachment
complicated by advanced proliferative vitreoretinopathy: in idiopathic
rhegmatogenous detachment, tractional detachment after perforating injury,
and in diabetic retinopathy. Vitreous surgery increased the limits of
operability in complicated retinal detachments.
5. Merrill PT; Buckley EG; Halperin EC.
New and recurrent tumors in germinal retinoblastoma: is there a treatment
effect?
Ophthalmic Genetics, 1996 Sep, 17(3):115-8.
(UI: 97061823)
Abstract: Patients with germinal retinoblastoma (those with bilateral disease
or positive family history) have a mutation which puts them at risk for
developing new tumors. It is unclear whether the frequency of new tumor
development is effected by the type of treatment employed. It may be
hypothesized that external beam radiation "sterilizes' the whole retina,
and thus decreases the risk of new and recurrent tumors. We reviewed our
experience with 66 eyes in 47 patients over the past ten years. We did not
find a significant difference in the incidence of new and recurrent
retinoblastoma among eyes treated with external beam radiation versus focal
modalities.
6. Morris DL.
Hepatic cryotherapy for cancer: a review and critique.
Hpb Surgery, 1996, 9(2):118-20.
Pub type: Journal Article; Review; Review, Tutorial.
(UI: 97025031)
7. Yeh KA; Fortunato L; Hoffman JP; Eisenberg BL.
Cryosurgical ablation of hepatic metastases from colorectal carcinomas.
American Surgeon, 1997 Jan, 63(1):63-8.
(UI: 97138048)
Abstract: Surgical resection remains the only curative therapy for hepatic
metastases from colon and rectal carcinoma. Many patients will be
unresectable or have close microscopic margins. Cryoablation may improve
local control and survival in those cases. From February 1992 to May 1995,
patients with metastatic colon and rectal carcinoma who underwent
cryoablation of surgical margins following hepatic resection or
cryoablation of hepatic metastases were reviewed with attention to patient
and tumor characteristics, clinical course, local control, and survival.
Twenty-four patients (10 female, 14 male) with a mean age of 63 years
(range, 34-84 years) underwent cryosurgical ablation for hepatic
metastases. Twelve were for central lesions and 12 for gross or
microscopically positive resection margins. Surgery was performed with
curative intent for 21 and for palliation in 3 patients. The mean hospital
stay was 8.4 days (range, 5-15 days). Complications included three cases of
parenchymal cracking and a single bile leak. Two of 14 patients who
developed pleural effusions required treatment. Perioperative mortality was
8.3 per cent (2 of 24): one myocardial infarction and one cerebrovascular
accident. Four of 21 treated for cure had hepatic recurrence, and six had
only extrahepatic recurrence. Median time to recurrence was 9.5 months.
With median follow-up of 19 months, mean actuarial disease-free (DFS) and
overall survival (OS) rates are as follows. Those with central lesions (n =
12) had a mean OS rate of 31 months and a mean DFS rate of 23 months. Those
with close resection margins (n = 12) had a mean OS rate of 31 months and a
median DFS rate of 19.5 months. Total patients (n = 24) had a mean OS rate
of 32.7 months and a mean DFS rate of 23.5 months. We conclude that
cryoablation of unresectable hepatic metastases or close resection margins
is safe and may allow for improved survival in selected patients with
metastatic colon and rectal carcinoma.
8. Aus G; Hugosson J.
[Cryosurgery--an alternative in prostatic cancer].
Lakartidningen, 1996 Dec 11, 93(50):4641-4.
Language: Swedish.
(UI: 97142595)
9. Devitt A; O'Sullivan T; Kavanagh M; Hurson BJ.
Surgery for locally aggressive bone tumours.
Irish Journal of Medical Science, 1996 Oct-Dec, 165(4):278-81.
(UI: 97144983)
Abstract: Treatment of 16 patients with aggressive benign bone tumours and one
patient with a low grade malignancy with a combined regimen of cryosurgery,
phenolization and acrylic cementation is reported. Patients were aged
between 9 and 51 years and were treated by this method between the years
1986 and 1993. Minimal follow up was 13 months. The commonest histological
diagnosis was giant cell tumour (7), followed by aneurysmal bone cyst (6),
chondromyxoidfibroma (3) and low grade chondrosarcoma (1). Patients were
assessed for functional outcome and local recurrence. On average 86 per
cent of premorbid function was restored at follow up and there was one
local recurrence (6.29 per cent). We conclude that this is a satisfactory
method of gaining local control of these tumours.
10. Mulvihill A; Fulcher T; Datta V; Acheson R.
Pneumatic retinopexy versus scleral buckling: a randomised controlled
trial.
Irish Journal of Medical Science, 1996 Oct-Dec, 165(4):274-7.
Pub type: Clinical Trial; Journal Article; Randomized Controlled Trial.
(UI: 97144982)
Abstract: Pneumatic retinopexy (PR) is a technique for repairing certain
retinal detachments which is easier to perform than conventional sceral
buckling (SB) surgery but has comparable results. We performed a
prospective, randomised, controlled trial to determine for ourselves
whether PR is a safe and acceptable procedure. Twenty patients presenting
consecutively with retinal detachments which fulfilled the selection
criteria were randomised to have their detachments repaired by either PR or
SB, ten patients in each group. The suitable patients had a single retinal
break or small group of breaks of not greater than one clock hour in size,
situated within the superior eight clock hours of retina. Patients with
significant proliferative vitreoretinopathy or other fundus disorders were
excluded. All patients in the PR group had local anaesthesia while all
those in the SB group had general anaesthesia. Successful reattachment of
the retina was achieved with one or more procedures in 90 percent of the PR
group and in 100 percent of the SB group. We feel that narrowing the
selection criteria for PR may further improve the success rate.
11. Nitrous oxide (N2O) cryosurgical units must be scavenged.
Health Devices, 1996 Aug, 25(8):306-9.
(UI: 97001181)
12. Zhang Y.
[Care of semicircular canal cryosurgery for Meniere's disease before and
after surgery].
Chung-Hua Hu Li Tsa Chih Chinese Journal of Nursing, 1995 Dec,
30(12):724-6.
Language: Chinese.
(UI: 96356682)
BIOSYS Database:
1. Rodriguez-Bigas, M A; Klippenstein, D; Meropol, N J; Weber, T K; Petrelli, N
J.
A pilot study of cryochemotherapy for hepatic metastases from colorectal
cancer.
Cryobiology, v.33, n.6, (1996): 600-606.
Abstract:
Cryosurgery of hepatic metastases from colorectal carcinoma is a form of
local therapy for unresectable disease. After curative resection, failures
occur in the liver, and at extrahepatic sites. This pilot study evaluated
the toxicity and tolerance to cryotherapy and intraoperative chemotherapy
for unresectable hepatic metastases from colorectal cancer. If after
exploratory celiotomy for potential curative resection of hepatic
metastases the patient was deemed unresectable because of location and/or
number of lesions, cryosurgery and intraoperative chemotherapy with
systemic 5-fluorouracil 600 mg/m-2 and leucovorin 500 mg/m-2 was
performed. Four patients were treated with cryochemotherapy. All patients
developed toxicity. Two patients developed grade III leukopenia on
Postoperative Days 2 and 12, and grades II and III diarrhea on
Postoperative Days 5 and 7, respectively. Grade III hyperbilirubinemia and
thrombocytopenia occurred in one patient on Postoperative Days 3 and 7.
Acute respiratory distress syndrome, postoperative ileus. and grade II
mucositis occurred in one patient each. All patients had delays and dose
reductions on their subsequent chemotherapy treatments secondary to
toxicity. Two patients had disease progression, one had stable disease,
and one is "disease free." Combining the tumoricidal effects of
chemotherapy and cryosurgery is in theory a good concept. However, the
toxicity of 5-FU and leucovorin is enhanced by this approach.
MedLine Database:
BIOSYS Database:
MedLine Database:
1. Downey D.
High-res ultrasound guides cryosurgery.
Diagn Imaging San Franc, 1996 Dec, 18(12):73-4, 77-8.
(UI: 97132798)
2. Kothari PS; Murphy M; Howells GL; Williams DM.
Hemangiopericytoma: a report of two cases arising on the lip.
British Journal of Oral and Maxillofacial Surgery, 1996 Oct, 34(5):454-6.
(UI: 97066261)
Abstract: Hemangiopericytoma is a rare tumour of pericytes; represents 1% of
all vasoformative tumours and 15-25% of those which occur in the head and
neck. We present two cases of hemangiopericytoma occurring on the lower lip
and report the use of cryosurgery to treat the most recent case.
3. Bourke RD; Dowler JG; Milliken AB; Cooling RJ.
Perimetric and angiographic effects of retinotomy.
Australian and New Zealand Journal of Ophthalmology, 1996 Aug, 24(3):245-9.
(UI: 97070201)
Abstract: AIM: We sought to characterise the morphological and functional
effects of drainage retinotomy on the vascular, neural, subretinal and
epiretinal components of the affected retina. PATIENTS AND METHODS:
Following successful retinal reattachment surgery involving drainage
retinotomy in 15 cases (retinotomy group) and no retinotomy in 14 cases
(control group), the existence, nature and quadrantic area of visual field
loss to a white III4e target was determined using kinetic Goldmann
perimetry. Vascular alterations were characterised using fluorescein
angiography with peripheral sequences. RESULTS: Visual field defects within
30 degrees of fixation were present in 12 of 14 (86%) of the retinotomy
group (including all eyes in which the retinotomy was sited within five
disc diameters of fixation) and none of the control group (Fisher exact
test, P = 0.00005). Following superonasal retinotomy, inferotemporal field
area (median area 82 units, range 44 to 128) was approximately half that
following superotemporal retinotomy (median area 167 units, range 119 to
192) (Wilcoxon's ranksum P = 0.003). No vascular abnormalities distal to
the retinotomy were identified, although subretinal neovascularization (two
eyes) and epiretinal membrane formation (one eye) occurred at the
retinotomy site. CONCLUSION: We recommended that where possible subretinal
fluid be drained via existing breaks, and if retinotomy is necessary, that
it should be sited more than five disc diameters from fixation in the
supertemporal quadrant to minimise visual field loss.
4. Falconieri G; Lugnani F; Zanconati F; Signoretto D; Di Bonito L.
Histopathology of the frozen prostate. The microscopic bases of prostatic
carcinoma cryoablation.
Pathology, Research and Practice, 1996 Jun, 192(6):579-87.
(UI: 97010608)
Abstract: In the last few years percutaneous cryoablation surgery of the
prostate has been re-introduced as an alternative means to treat prostatic
carcinoma. Advantages of the technique include local effectiveness in
eradicating tumors, minimal morbidity rate and lower costs when compared to
radical surgery. We report a study documenting the histopathological
changes seen in 317 biopsy specimens obtained from 30 patients (age range
59-83 years, median 73 years) treated with cryosurgical ablation for
prostate cancer. Pre- and postoperatory assessment was inclusive of plain
clinical, laboratory and instrumental data (digital rectal examination,
transrectal ultrasound scan, serum prostatic specific antigen
concentration) and systematic biopsies obtained from conventional and
modified prostate sextants. Fifteen patients had tumors extending through
the prostate capsule (pT3 and pT4). Six patients had stage PT1 tumors and 9
had stage pT2. Tissues were sampled at 3, 6 and between 12-18 months
postoperatively. The histologic findings, in decreasing order of frequency,
were: full core fibrosis, necrosis, granulation tissue, basal cell
hyperplasia, cell swelling, hemosiderin deposits, chronic inflammation,
thick nerves and prostatic hyperplasia. Necrosis was of the coagulative
type, sometimes associated with nuclear debris, and seen at relatively
short interval from cryotherapy. Fibrosis with hyaline qualities was seen
especially at 12-18 month interval. The presence of necrosis, as well as
granulation tissue, hemosiderin deposits and cell swelling, strongly
correlate to intervals from cryosurgical ablation. Residual tumor tissue
was focal (0.5-1 mm) and recognizable in 9 cores from 4 patients (13.3%)
sampled especially from the prostatic apex. Incipient tumor necrosis was
seen in 11 cores, without particular distribution. These findings indicate
that cryosurgery results in distinctive changes in both tumoral and
non-tumoral prostate tissue. Knowledge of the histopathologic patterns is
important since it provides the clinicians with information on treatment
efficacy or failure, and could assist in the selection of larger groups of
patients eligible to cryosurgical ablation.
5. Litvinenko AA.
[Long term results of cryosurgical treatment of liver neoplasms].
Klinicheskaia Khirurgiia, 1996(6):31-3.
Language: Russian.
(UI: 97139190)