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Enhanced renal parenchymal cryoablation with novel 17-gauge cryoprobes.

机译:新型17规格冷冻棒增强了肾实质冷冻消融。

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OBJECTIVES: To evaluate novel, 17-gauge cryoprobes with a modified heat exchange mechanism to evaluate the area of ablation that could be achieved with 17-gauge (1.47-mm) cryoprobes. METHODS: Eleven pigs were divided into four groups. Each animal underwent laparoscopic creation of three cryolesions with an ellipical iceball-generating 17-gauge cryoprobe (group 1), one that generates a teardrop-shaped iceball (group 2), a template of three standard 17-gauge cryoprobes (group 3), or a single, standard, large-caliber (3.4-mm) cryoprobe (group 4). Each cryolesion was created with a standard double-freeze cycle. Intraoperative ultrasonography was used to measure the maximal iceball dimensions, and the renal temperatures were measured with a thermocouple. The animals were killed after 14 days. The gross lesion size and histopathologic area of necrosis were documented. RESULTS: The mean temperature for the surrounding renal parenchyma was not significantly different among the groups. No statistically significant difference was noted in the size of the gross or histopathologic lesions created among the four groups. The gross lesion size correlated statistically significantly with the histologic area of necrosis (P <0.01). CONCLUSIONS: Despite the diminutive size of the 17-gauge cryoprobes tested, the probes ablated tissue volumes equivalent to that ablated using the larger, standard 3.4-mm cryoprobe or a configuration of three standard 17-gauge cryoprobes. These novel 17-gauge cryoprobes may facilitate ablation of small and medium-size renal tumors and may have expanded application for percutaneous ablation owing to the decreased risk of hemorrhage.
机译:目的:评估具有改进的热交换机制的新型17规格低温冷冻机,以评估17规格(1.47毫米)低温冷冻机可实现的消融面积。方法:将十一头猪分为四组。每只动物都用产生椭圆形冰球的17号冰冻探针(第1组)进行腹腔镜下的三个冷冻分离,其中一个产生泪滴形冰球(第2组),三个标准的17号冰冻冷冻球(第3组)的模板,或单个标准的大口径(3.4毫米)冷冻探针(第4组)。每个标准件均以标准的两次冻结周期创建。术中超声用于测量最大冰球尺寸,并用热电偶测量肾脏温度。 14天后将动物处死。记录总的病变大小和坏死的组织病理学区域。结果:各组周围肾实质的平均温度无明显差异。在四组之间形成的肉眼或组织病理学病变的大小上没有统计学上的显着差异。病变总面积与坏死的组织学面积在统计学上具有显着相关性(P <0.01)。结论:尽管所测试的17号冷冻探针尺寸较小,但探针的消融组织体积相当于使用较大的标准3.4毫米冷冻探针或配置的三个标准17号冷冻探针消融的组织体积。这些新型的17规格低温冷冻器可能有助于消融中小规模的肾脏肿瘤,并且由于降低了出血的风险,可能已扩大了经皮消融的应用范围。

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