`Xh h0 @@@ @@@@0!>=hh@ EN DB hP     & . 6F {> qi  R u7 2   %+ 0 BIa fmY bYHncet 353n 91650*12 patients. RITA Model 30, No recurrences PDF ,126 PM:10335793r1 Akhter1997 Allen1998 Arca19981? Ashton1998@Atkinson1995AAtkinson1995+ Babinchak1997 Bagia1998I Bahn1994F Bahn1995& Baker1996 Baust1994 Baust1998 Bayjoo1991: Bijzet20011 Bilchik19970 Bilchik1998 Blackwell1999  Blackwell2000 Blair19985 Bolton19999# Booth1995 Brigham2000' Cady1991D Cady19977% Caplehorn1995V Cha2001 Chang1994 Chapman1998 Chapman1999  Chapman2000> Chapman20013 Chinn1997 Chosy19973 Chosy1997= Chosy1998H Chosy1998M Chosy1998N Chosy1998 Chosy1999L Chosy1999< Christians1999 Christman1999  Christman2000% Clingan1995' Clouse19911  Cooper1978:  Cozzi1994  Cozzi1995 Cuschieri1995 Cuschieri1999 D'Angelica1998, De Cian2000  de Jong2001 de Vries20010 Debelak1999 Debelak2000> Debelak2001* Delay1996 Di Bonito1996) Drukier1983 Dutta1977 Dwerryhouse1998 Dwerryhouse1998E Eichler1976 El Shakhs1999 Englund1995 Falconieri1996 Fan19981 Fehringer20004 Feifel199891 Feifel20000" Feliciotti1998) Feuerbach1983 Fidler20010 Finkelstein1994 Finlay2000* Finzy1996 Fong19988 Fraser1978:, Frering2000 Gage19777 Gage1982 Gage19828 Gage1998 Gagner19989 Gainer20000, Gignoux2000> Gobbell2001 Goepel1991:F Gontina1995* Gory19966" Guerrieri1998 Haddad1998 Harley1999h Helling2000Heniford1998 Hewitt1997 Hewitt19985 Hewitt19999 Hodyl1998; Horton19959Iannitti1998 Iqbal1998 Jacob1991' Jenkins1991D Jenkins1997W Junginger19985 Junginger1999* Kaemmerlen1996, Kaemmerlen2000 Kahlenberg1998' Kane1991D Kane1997% King1995FKlionsky1995: Klipfel1996 Klippenstein1998 Korpan1997D Kruskal1997 Kuhlman1999 Lam1995 Lam1997 Lam1998I Lee1994I Lee1994F Lee1995F Lee1995  Lee19973 Lee1997 Lee1998= Lee1998H Lee1998M Lee1998N Lee1998 Lee1999L Lee1999V Lee2001E Lenz19769D Lewis1997" Lezoche1998 Limburg2001 Littrup1997 Littrup1999L Littrup1999 Lugnani1996" Lugnani1998 Ma1994t MacIver1978 Mahvi19973 Mahvi1997= Mahvi1998 Mahvi1999L Mahvi1999V Mahvi2001/ Mascarenhas1998& McAuliffe1996# McCall1995 McCall19988I McHugh1994D McPhee1997, Meeus20001 Menger20000* Molina19961 Montes1977 Montes1982M Moon19988N Moon19988 Morris19944 Morris19955# Morris1995% Morris19955; Morris19959 Morris1997 Morris1998: Morris19988 Morris19982 Morris19988W Morris199895 Morris199996 Morris199997 Morris19999X Morris19999 Morris20000H Nakada1998M Nakada1998N Nakada1998V Nguyen2001V Niederhuber2001> Olson2001I Onik19949 Onik19977"Paganini1998 Parker20000 Penetrante19989 Perera1998:Petrelli19989 Pinson19988 Pinson1999h Pinson200004 Pistorius19981 Pistorius2000< Pitt1999sU Poston2001%Preketes1995;Preketes1995& Quebbeman1996< Quebbeman1999 Ramming19970 Ramming1998( Ravikumar1989' Ravikumar1991/ Ravikumar1998& Redlich1996 Rees19919) Reiser1983V Rikkers2001+ Riley1997* Rivoire1996, Rivoire2000Rodriguez-Bigas1998% Ross19959; Ross19959 Ross19988+Rotheram19977 Rottier2001Sarantou19970Sarantou1998 Scanlan19974 Schneider1998 Schot19994 Schuder19981 Schuder2000 Seifert19982 Seifert1998W Seifert19985 Seifert19996 Seifert19997 Seifert1999X Seifert1999 Seifert2000: Shafir1996: Shapiro1996 Shimi1995 Shimi1997 Shimi1999> Shyr2001i: Sicular1996 Signoretto19969 Silverstein1997 Slooff20010F Solomon19959 Staren1997( Steele19899' Steele199118 Steele1994 Stewart1994; Stewart19955 Stewart1999 Stewart2000: Sung19969> Sztipanovits2001" Tamburini1998C Tang1998* Treilleux1996) Ultsch198339 Velasco1997Venkatakrishnan1999* Voiglio19961 Vollmar2000 Volpe1998  von Geusau2001< Wallace1999 Walsh1998 Wardlaw1997: Warner199663 Warner1997= Warner1998H Warner1998M Warner1998N Warner1998 Warner19999L Warner19999 Washington1999> Washington2001@ Weaver1995A Weaver1995+ Weaver19979? Weaver19983 Weber1997= Weber1998L Weber1999Williams1999a Wong19977 Wright19988 You1998 Yuen1998 Zanconati1996@ Zemel1995A Zemel1995+ Zemel1997? Zemel1998 Zhao19979 Zhao1998sC Zhou1998C Zhou19988sC Zhou1998C Zhou1998C Zhou1998998sC Zhou1998998sC Zhou1998998sC Zhou1998C Zhou1998 Zhou1998998sC Zhou1998998sC Zhou19988sC Zhou19988sC Zhou19988sC Zhou19988sC Zhou1998C Zhou1998C Zhou1998998sC Zhou1998C Zhou1998 Zhou19988sC Zhou1998C Zhou1998 Zhou1998C Zhou19988sC Zhou19988sC Zhou1998C Zhou1998C Zhou1998C Zhou1998C Zhou1998 Zhou1998C Zhou19988sC Zhou19988sC Zhou19988sC Zhou1998C Zhou1998 Zhou19988sC Zhou1998998sC Zhou19981998sC Zhou1998998sC Zhou19988sC Zhou19988sC Zhou1998C Zhou1998Zhao1998sC Zhou19988sC Zhou1998998sC Zhou1998$1 & 94"2%#(')+*-.5$00 :;MC -ULR- RUFL-ULR-S0499-401-0 U I-  MPDI- A U-  DA -' T I-  BA - M H- OS - C M-  RU L- ULR-F RUSL- 490-9 1400- <<<<< AuthorsJournals /Keywords /                               ,0F  Akhter, J. Allen, P.J. Arata, M. A. Arca, M.J. Ashton, J.G. Atkinson, D.Babinchak, T.J. Bagia, J.S. Bahn, D. K. Baker, E.J. Baust, J. Bayjoo, P. Bijzet, J. Bilchik, A. Bilchik, A.J.Blackwell, T.S. Blair, T.K.Blumgart, L.H. Bolton, E.J. Booth, M.W. Brigham, K.L. Cady, B Cady, B. Cance, W.G.Caplehorn, J.R. Cha, C. Chang, Z. Chapman, W.C. Chinn, D. O. Chinn, D.O. Chosy, S. G. Chosy, S.G.Christians, K.K.Christman, J.W. Clark, T. W. Clingan, P.R. Clouse, M. Cooper, A.J. Cozzi, P.J. Cuschieri, A.D'Angelica, M. De Cian, F. de Jong, K.P.de Vries, E.G. Debelak, J.P. Delay, E.DeMatteo, R.P. Di Bonito, L. Drukier, A.K. Dutkowski, P. Dutta, P.Dwerryhouse, S.J. Eichler, J.El Shakhs, S.A. Engelmann, R. Englund, R.Falconieri, G. Fan, S.T. Fehringer, M. Feifel, G.Feliciotti, F. Feuerbach, S. Fidler, V.Finkelstein, J.J. Finlay, I.G. Finzy, J. Fong, Y. Fong, Y.M. Fraser, J.D. Frering, B. Gage, A.A. Gage, A.M. Gagner, M. Gainer, K.A. Gignoux, B. Gobbell, C. Goepel, J.R.Goldberg, S. N. Gontina, H. Gory, F. Guerrieri, M. Haddad, F.F. Harley, D.H. Helling, T.S.Heniford, B.T. Hewitt, P.M. Hodyl, C. Horigome, H. Horton, M.Huertas, J. C.Iannitti, D.A. Iqbal, J. Itoh, M. Jacob, G.Jarnagin, W.R. Jenkins, R. Jenkins, RL. Junginger, T.Kaemmerlen, P.Kahlenberg, M.S.@ 8Variable results of open, percutaneous, and laparoscopic cryosurgery of the kidney have been reported. Minimally invasive approaches to lower-pole renal ablation were prospectively compared in swine: laparoscopic puncture cryoablation preceded by arterial embolization, laparoscopic contact cryosurgery, and arterial embolization alone. Eighteen kidneys in nine domestic pigs were randomized to one of three treatment groups of six organs each: (1) puncture cryotherapy preceded by selective lower-pole arterial embolization; (2) contact cryotherapy alone; and (3) arterial embolization alone. Under general anesthesia, appropriate animals underwent selective arterial embolization of the lower pole via femoral cutdown using Gelfoam pledgets. Animals randomized to cryotherapy underwent dissection of the lower pole of the kidney using a single 12-mm umbilical and two midclavicular-line ports in the lateral position. Under external ultrasound guidance, two 3-mm cryoprobes (Cryomedical Sciences, Rockville, MD) were positioned in the lower pole of the kidney, and double-freeze technique to -190 degrees C was performed using puncture or contact application. Ultrasonography was used to guide probe insertion during puncture cryotherapy only. Kidneys were harvested 11 to 14 days after the procedure. Both puncture and contact kidneys demonstrated cell death and subsequent necrosis by light microscopy and electron micrography. On average, puncture lesions were heavier than contact lesions, 19.3 g v 10.1 g (P = 0.02; unpaired t-test), whereas the kidneys were equivalent in weight: 74.1 g v 74.1 g. Puncture lesions represented 26.4% of total kidney weight v 13.5% in the contact group (P = 0.002; unpaired t-test). Only focal infarcts were identified in the embolization group. No evidence of adjacent visceral injury was identified in any of the groups, and no animal required conversion to open laparotomy. One kidney bled after contact cryotherapy, and hemostasis was achieved laparoscopically. Laparoscopic cryotherapy is reproducible and effective using either the puncture technique preceded by arterial embolization or the contact technique, without evidence of damage to adjacent structures. Contact lesions were less voluminous and more peripheral than puncture lesions. Embolization alone produces focal infarcts and focal zones of cell death.'\UDepartment of Surgery, University of Wisconsin, Madison, USA. nakada@surgery.wisc.eduJDNakada, S. Y. Lee, F. T., Jr. Warner, T. F. Chosy, S. G. Moon, T. D. 0892-7790 Journal Article J EndourolAnimal Comparative Study *Cryotherapy Female Kidney Diseases/pathology/*therapy *Laparoscopy Microscopy, Electron Punctures Support, Non-U.S. Gov't *Surgical Procedures, Minimally Invasive Swinejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9895264 /`("Hepatectomy/ct [Contraindications] Hepatectomy/mo [Mortality]Hepatectomy/mt [Methods]Hepatic ArteryHEPATIC CRYOSURGERYHEPATIC METASTASEShepatic neoplasms Hepatic Veins/pa [Pathology]$Hepatic Veins/ra [Radiography]hepatic vesselsHEPATOCELLULAR-CARCINOMAHumanHypothermia,InducedHypothermia/et [Etiology]Ice ICE FORMATIONIce/an [Analysis] immunology In Vitro Incidence Inflammations,&Inflammation Mediators/me [Metabolism]\crInfusions, IntravenousInfusions,Intravenous injuries-instrumentationab(#Intestinal Neoplasms/pa [Pathology]y]INTRACELLULAR ICEIntraoperative Period$INTRAOPERATIVE ULTRASONOGRAPHY Kidney Pi("Kidney Diseases/pathology/*therapy("Kidney Failure, Acute/epidemiology("Kidney Failure,Acute/et [Etiology]0+Kidney Tubular Necrosis,Acute/et [Etiology]0*Kidney/*pathology/*surgery/ultrasonographyKidney/pathology/*surgery Kidney/pp [Physiopathology]amKidney/su [Surgery]th LaparoscopyLaparoscopy/*methods LaparotomytesLaparotomy/methodsLeiomyosarcomasmsLength of Stay,'Leucovorin/ad [Administration & Dosage] Life Tables LigationuLiver Liver Abscess/et [Etiology] Liver Diseases/su [Surgery]atLiver Function TestsLIVER METASTASESsliver neoplasmLiver Neoplasms Liver Neoplasms, Experimental0+Liver Neoplasms,Experimental/pa [Pathology],)Liver Neoplasms,Experimental/su [Surgery] Liver Neoplasms/bl [Blood]o [("Liver Neoplasms/co [Complications]$Liver Neoplasms/di [Diagnosis]$!Liver Neoplasms/dt [Drug Therapy]$Liver Neoplasms/mo [Mortality]ort0,Liver Neoplasms/mortality/secondary/*surgery84Liver Neoplasms/mortality/secondary/surgery/*therapy$Liver Neoplasms/pa [Pathology]se)@=Liver Neoplasms/radiography/secondary/surgery/ultrasonography$Liver Neoplasms/sc [Secondary]]s] Liver Neoplasms/su [Surgery]hLiver Neoplasms/surgery Liver Neoplasms/th [Therapy]y($Liver Neoplasms/us [Ultrasonography]liver resectionLiver/*pathologyLiver/*surgeryLiver/bs [Blood Supply]Liver/en [Enzymology]Liver/im [Immunology]Liver/in [Injuries]Liver/me [Metabolism]Liver/pa [Pathology],(Liver/pathology/*surgery/ultrasonography84Liver/pathology/radiography/*surgery/ultrasonography Liver/pp [Physiopathology]Liver/ra [Radiography]0*Liver/radiography/*surgery/ultrasonographyLiver/su [Surgery]per Liver/us [Ultrasonography]LungrLung/me [Metabolism]]Lung/pa [Pathology]]]LymphLymph/ph [Physiology]Lymphatic Metastasis Magnetic Resonance ImagingMaler Mathematics mechanisms Melanoma metabolism METASTASES methodseo METHYL-CCNUMice Mice, Nude$Microcirculation/pa [Pathology]Microscopy, Electron$Microscopy, Video/mt [Methods]Microscopy,Electrony]Microscopy,Fluorescence Middle Age[PhMiniaturizationryminimally invasiveMODELModels,BiologicalMonitoring,Intraoperative,&Monitoring,Intraoperative/mt [Methods]Monokines/bl [Blood]] Morbidity mortality(#Multiple Organ Failure/epidemiologyMultivariate AnalysisMyocardial Infarction Myoglobinuria/et [Etiology] Necrosisy,)Neoplasm Recurrence, Local/di [Diagnosis]Neoplasm Recurrence,Local0+Neoplasm Recurrence,Local/ep [Epidemiology],&Neoplasm Recurrence,Local/th [Therapy]Neoplasm StagingNeoplasm,ResidualNeoplasms/su [Surgery]Neuroendocrine Tumors("Neuroendocrine Tumors/su [Surgery]]y]("Neuroendocrine Tumors/th [Therapy] NF-kappa Bbl NF-kappa B/me [Metabolism][Ph Nitrogeni(%Nitrogen/ad [Administration & Dosage] Nitrogen/tu [Therapeutic Use] North America/epidemiologyPalliative CareTuPancreatic Neoplasms(#Pancreatic Neoplasms/pa [Pathology]y] Paraganglioma/sc [Secondary]h Paraganglioma/su [Surgery]y]h   313piCryosurgery causes a profound reduction in tumor markers in hepatoma and noncolorectal hepatic metastases82Bilchik,A.J. Sarantou,T. Wardlaw,J.C. Ramming,K.P. 1997 9/1997*Carcinoma,Hepatocellular/su [Surgery] *Cryosurgery *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] *Tumor Markers,Biological/bl [Blood] 0 (Tumor Markers,Biological) Carcinoma,Hepatocellular/bl [Blood] Carcinoma,Hepatocellular/mo [Mortality] Cryosurgery Female Follow-Up Studies Human Liver Liver Neoplasms/bl [Blood] Liver Neoplasms/mo [Mortality] Male Middle Age Neuroendocrine Tumors Palliative Care surgery Survival Rate therapy Time Factors United Statesr796-800uAmerican Surgeon639mb[Cryosurgical ablation of hepatic metastases from colon carcinoma has become a useful adjunct in the management of patients whose tumors are not amenable to surgical resection. We evaluated cryoablation of hepatoma and noncolorectal hepatic metastases by examining its effect on serum levels of tumor markers in 20 patients with primary liver cancer (N = 5) or liver metastases (N = 15) from breast cancer, neuroendocrine tumors, ovarian cancer, and thyroid cancer. All patients had failed conventional therapy and had no evidence of extrahepatic spread. After cryosurgery, 17 patients had a significant decrease in tumor marker levels (median 77%) and a significant improvement in symptoms. One patient died of nontumor causes, and five patients died of recurrent disease. Median interval to death or last follow-up was 28.3 months overall (range, 2-45 months), 17.9 months for nonsurvivors (range, 2-44 months), and 35.2 months for survivors (range, 26-45 months). Median survival was 32 months following curative surgery (range, 16-45 months) and 25 months following palliative surgery (range, 2-42 months). Cryosurgical ablation of noncolorectal hepatic metastases and primary hepatomas produces a profound reduction in serum levels of tumor markers. It is safe, provides excellent palliation of symptoms, and in selected patients can be performed with curative intentRKDB - MEDLINE UI - 97435857 IN - Cancer Center of Century City Hospital, Los Angeles, California, USA JC - 43e, 0370522 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199709 Revised: 20001218. Entry Week: 199709 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0003-1348 240o|Acute lung injury after hepatic cryoablation: correlation with NF-kappa B activation and cytokine production. [see comments]Blackwell,T.S. Debelak,J.P. Venkatakrishnan,A. Schot,D.J. Harley,D.H. Pinson,C.W. Williams,P. Washington,K. Christman,J.W. Chapman,W.C.l 1999 9/1999*Cryosurgery/ae [Adverse Effects] *Cytokines/bi [Biosynthesis] *Liver/su [Surgery] *Lung/in [Injuries] *NF-kappa B/me [Metabolism] 0 (Cytokines) 0 (Inflammation Mediators) 0 (macrophage inflammatory protein 2) 0 (Monokines) 0 (NF-kappa B) 0 (Tumor Necrosis Factor) Acute Disease Animal Comparative Study Cryosurgery Disease Models,Animal Hepatectomy Hepatectomy/ae [Adverse Effects] Human Inflammation Mediators/me [Metabolism] injuries Liver Liver/me [Metabolism] Lung Lung/me [Metabolism] Lung/pa [Pathology] methods Monokines/bl [Blood] mortality Necrosis NF-kappa B Rats Rats,Sprague-Dawley Support,Non-U.S.Gov't Support,U.S.Gov't,Non-P.H.S. surgery Time Factors Tumor Necrosis Factor/me [Metabolism] United States Inflammation518-526Surgery 1263BACKGROUND: Previous clinical reports have documented multisystem organ injury after hepatic cryoablation. We hypothesized that hepatic cryosurgery, but not partial hepatectomy, induces a systemic inflammatory response characterized by distant organ injury and overproduction of nuclear factor kappa B (NF-kappa B)-dependent, proinflammatory cytokines. METHODS: In this study, rats underwent either cryoablation of 35% of liver parenchyma or a similar resection of left hepatic tissue. Serum tumor necrosis factor-alpha and macrophage inflammatory protein-2 levels and NF-kappa B activation were assessed by electrophoretic mobility shift assay at 30 minutes 1, 2, 6, and 24 hours after either procedure. RESULTS: Cryoablation of 35% of liver (n = 22 rats) resulted in lung injury and a 45% mortality rate within 24 hours of surgery, whereas 7% treated with 35% hepatectomy (n = 15 rats) died during the 24 hours after surgery (P < .05, cryoablation vs hepatectomy). Serum tumor necrosis factor-alpha and macrophage inflammatory protein-2 levels were markedly increased in rats (n = 10 rats) 1 hour after hepatic cryoablation compared with rats that underwent partial hepatectomy (P < .005). We evaluated NF-kappa B activation by electrophoretic mobility shift assay in nuclear extracts of liver and lung after cryosurgery and found that NF-kappa B activation was strikingly increased in the liver but not the lung at 30 minutes and in both organs 1 hour after cryosurgery, and returned to baseline in both organs by 2 hours. In rats undergoing 35% hepatectomy, no increase in NF-kappa B activation was detected in nuclear extracts of either liver or lung at any time point. CONCLUSIONS: These data show that hepatic cryosurgery results in systemic inflammation with activation of NF-kappa B and increased production of NF-kappa B-dependent cytokines. Our data suggest that lung injury and death in this animal model is mediated by an exaggerated inflammatory response to cryosurgeryDB - MEDLINE UI - 99416058 IN - Division of Hepatobiliary Surgery, Vanderbilt University Medical Center, Nashville, Tenn. 37232-4753, USA CM - Comment in: Surgery. 2000 Apr;127(4):477-8 JC - vc3, 0417347 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 19990928 Revised: 20001218. Entry Week: 19990928 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0039-6060 0zing*Heat 556f`Histopathology of the frozen prostate. The microscopic bases of prostatic carcinoma cryoablationF@Falconieri,G. Lugnani,F. Zanconati,F. Signoretto,D. Di Bonito,L. 1996 6/1996&*Carcinoma/pa [Pathology] *Carcinoma/su [Surgery] *Cryosurgery/ae [Adverse Effects] *Prostatic Neoplasms/pa [Pathology] *Prostatic Neoplasms/su [Surgery] Aged Aged,80 and over Biopsy Cryosurgery Cryotherapy Human Inflammation Male Middle Age Morbidity Necrosis pathology Prostate surgery579-587$Pathology, Research & Practice 1926In 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`YDB - MEDLINE UI - 97010608 IN - Department of Anatomic Pathology, Ospedale Maggiore, Trieste University, Italy JC - pbz, PBZ, PBZ, 7806109 Journal Subset AIM Journals CP - Germany PT - Journal Article LG - English EM - 199702 Revised: 20001218. Entry Week: 199702 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0344-0338 I 402hbHepatic cryosurgery for recurrent hepatocellular carcinoma after hepatectomy: a preliminary report"Lam,C.M. Yuen,W.K. Fan,S.T. 1998 6/1998*Carcinoma,Hepatocellular/su [Surgery] *Cryosurgery *Hepatectomy *Liver Neoplasms/su [Surgery] *Liver/su [Surgery] *Neoplasm Recurrence,Local/su [Surgery] analysis blood Carcinoma,Hepatocellular/pa [Pathology] complications Cryosurgery Cryosurgery/mo [Mortality] Hepatectomy Hepatectomy/mo [Mortality] Human Liver Neoplasms/pa [Pathology] Male methods Middle Age Postoperative Complications Prognosis Reoperation Retrospective Studies Risk surgery therapy Treatment Outcome United Statese104-106g"Journal of Surgical Oncology682t^WBACKGROUND AND OBJECTIVES: The treatment of choice for recurrent hepatocellular carcinoma (HCC) is repeated resection. However, only a small percentage of patients are suitable for further hepatic resection. The aim of this study was to evaluate the surgical risk and operative outcome of hepatic cryosurgery in patients with recurrent HCC. METHODS: A retrospective analysis of patients with recurrent HCC after previous curative hepatectomy treated with cryosurgery. Four patients with recurrent HCC not suitable for further resection were enrolled for cryosurgery, their clinical parameters, the operative details and outcome were studied. RESULTS: No intraoperative or postoperative complications were noted. The duration of operation ranged from 3-5.2 hr and the operative blood loss from 173-1,300 ml. All patients are still alive with survival after cryosurgery ranging from 12-23 mo (25-63 mo after the hepatic resection). Three patients showed evidence of recurrent disease and one patient was disease free. CONCLUSIONS: Hepatic cryosurgery is a safe therapy for patients with unresectable recurrent HCC=f`DB - MEDLINE UI - 98285520 IN - Department of Surgery, University of Hong Kong, Queen Mary Hospital, China JC - k79, K79, K79, 0222643 Journal Subset Index Medicus CP - United States PT - Journal Article LG - English EM - 19980623 Revised: 20001218. Entry Week: 19980623 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0022-47908058945. 192e3M 1994 Seps<6US-guided percutaneous cryoablation of prostate cancer 769-76A tailored approach to cryosurgery of prostate cancer is presented. The authors have performed 214 cryoprocedures to date with use of this protocol. The technique requires pretreatment with androgen ablation therapy, preoperative diagnosis and staging with ultrasound (US)-guided biopsies, and detailed knowledge of prostate and rectal anatomy. Five cryoprobes are placed in the prostate under US guidance in a configuration that depends on tumor location, sites of extracapsular extension, the size of the tumor, and gland geometry. Freezing starts anteriorly to keep from obstructing the ultrasound beam. Two freezes are performed at the known cancer site, and additional freezes are performed, if necessary, to include the remainder of the gland. Thermosensors enable monitoring of the cryosurgical ice ball and determination of the number of freezes. Cryosurgery is always performed by a urologist and a radiologist working together.'HBDepartment of Radiology, Crittenton Hospital, Rochester, MI 48307.D=Lee, F. Bahn, D. K. McHugh, T. A. Onik, G. M. Lee, F. T., Jr. 0033-8419 Journal Article RadiologyCryosurgery/*methods Gonadorelin/administration & dosage Human Male Preoperative Care Prostatic Neoplasms/*surgery *Punctures Support, Non-U.S. Gov't *Ultrasonography, Interventionaljdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8058945:3Hepatic cryosurgery with intraoperative US guidance VPLee,F.T.,Jr. Mahvi,D.M. Chosy,S.G. Onik,G.M. Wong,W.S. Littrup,P.J. Scanlan,K.A. 1997 3/1997Adult Aged Animal Cryosurgery Female Human instrumentation Intraoperative Period Liver Liver Neoplasms Male methods Middle Age radiography secondary surgery Ultrasonography Ultrasonography,Interventional United StatesUI - 97203433 LA - eng PT - Journal Article DA - 19970328 IS - 0033-8419 SB - AIM SB - IM CY - UNITED STATES JC - QSH RefMgr field[1]: Journal RefMgr field[8]: Not in File624-632 Radiology 2023J'd^Department of Radiology, University of Wisconsin Hospital and Clinics, Madison 53792-3252, USA134 PM:9051005?l>7Treatment of colorectal liver metastases by cryotherapy& Weaver,M.L. Ashton,J.G. Zemel,R. 1998 3/1998 Adult Aged blood Carcinoembryonic Antigen Colorectal Neoplasms Cryosurgery Cryotherapy Female Human immunology Liver Liver Neoplasms Male methods Middle Age mortality pathology Recurrence secondary surgery Survival Analysis Survival Rate Treatment Outcome United StatesUI - 98153906 LA - eng RN - 0 (Carcinoembryonic Antigen) PT - Journal Article DA - 19980312 IS - 8756-0437 SB - IM CY - UNITED STATES JC - SSO RefMgr field[1]: Journal RefMgr field[8]: Not in File163-170Semin.Surg.Oncol.142"One hundred fifty-eight procedures were performed on 136 patients with unresectable hepatic metastases using hepatic cryotherapy to ablate the tumors. The median age was 62 years. Patients included 90 males and 46 females. Fifty-eight patients had synchronous metastases, 55 had bilobar lesions, and 90 had precryo chemotherapy. Median preoperative carcinoembryonic antigen (CEA) level was 14.4 ng/dl. The numbers of lesions treated, frozen, and resected were two and one. Median survival of all patients was 30 months. Survival for 39 patients was 37 months. Patients with a CEA level > 100 ng/dl had a statistically worse survival rate than those with a level < 100 ng/dl (P < .001). Twenty patients underwent recryotherapy with median survival of 34 months. Recurrent disease developed in 78% of patients--82% of the patients developed liver recurrence. Complication rates were comparable to liver resection. Operative mortality was 3.7%. Hepatic cryotherapy is effective and safe in treating colorectal hepatic metastases under ultrasound guidance'TMAllegheny General Hospital, Pittsburgh, Pennsylvania, USA. mweaverl@aherf.edu516 PM:9492886  281aF?The effects of hepatic cryosurgery on tumor growth in the livero@9Allen,P.J. D'Angelica,M. Hodyl,C. Lee,J. You,Y.J. Fong,Y.i 19987/1/1998y*Carcinoma,Hepatocellular/im [Immunology] *Carcinoma,Hepatocellular/su [Surgery] *Cryosurgery *Liver Neoplasms/im [Immunology] *Liver Neoplasms/su [Surgery] 635-65-4 (Bilirubin) Alanine Transaminase/bl [Blood] Alkaline Phosphatase/bl [Blood] Animal Aspartate Transaminase/bl [Blood] Bilirubin/bl [Blood] Carcinoma,Hepatocellular/pa [Pathology] Cell Division Cryosurgery EC 2-6-1-1 (Aspartate Transaminase) EC 2-6-1-2 (Alanine Transaminase) EC 3-1-3-1 (Alkaline Phosphatase) Hepatectomy Liver Liver Neoplasms/pa [Pathology] Male methods Rats Rats,Inbred BUF Spleen/cy [Cytology] Spleen/im [Immunology] surgery United States Laparotomy132-136"Journal of Surgical Research772Rat model (hepatoma cel line McA-RH7777). Hepatectomy leads to stimulation of residual tumor growth but cryo does not. No evidence for tumor immunity development (hypothesis that residual dead cells following cryo serve as tumor antigen)"BACKGROUND: The effects of hepatic cryosurgery on residual hepatic tumor growth, and on tumor immunity, have not been determined. MATERIALS AND METHODS: Two experiments were performed. In both, animals (n = 10 per group) had solitary left lobe hepatomas established, and underwent left lobectomy, cryoablation, or control laparotomy. Experiment I: immediately after tumor treatment, intraportal challenge of hepatoma cells was performed to evaluate for the effects of treatment on residual hepatic tumor growth. Experiment II: animals were challenged 14 days after tumor treatment, and splenocyte cytotoxicity assays were performed to evaluate for tumor immunity. Hepatic tumor nodules were counted 3 weeks after challenge in both experiments. RESULTS: In animals challenged immediately after tumor treatment, the mean number of liver nodules at 3 weeks was similar between control and cryoablation groups (65 +/- 13 vs 115 +/- 38, P = 0.17). Animals that had undergone resection, however, had a significant increase in the mean number of nodules as compared to cryoablation (278 +/- 74 vs 115 +/- 38, P = 0. 04) and control (278 +/- 74 vs 65 +/- 13, P = 0.002) animals. In addition, only resection animals had elevation in serum levels of the growth factor FGF-basic, 48 h after treatment (mean = 30 +/- 14 pg/ml). In animals challenged 14 days following treatment, all groups had similar numbers of nodules (resection vs cryoablation, P = 0.8). Splenocyte cytotoxicity was not increased after cryosurgical treatment. CONCLUSIONS: Unlike partial hepatectomy, cryoablation of hepatomas in rats does not accelerate residual tumor growth in the liver or result in production of the growth factor FGF-basic. We did not find evidence for the development of tumor immunity following cryosurgery. Copyright 1998 Academic PresszsDB - MEDLINE UI - 98406337 IN - Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, 10021, USA JC - k7b, K7B, K7B, 0376340 Journal Subset Index Medicus CP - United States PT - Journal Article LG - English EM - 19980924 Revised: 20001218. Entry Week: 19980924 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0022-4804#R 356JDHepatic cryotherapy for metastatic liver tumours. [Review] [26 refs]("McCall,J.L. Booth,M.W. Morris,D.L. 1995 10/18/1995*#*Cryotherapy/mt [Methods] *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/th [Therapy] Colorectal Neoplasms/pa [Pathology] Cryotherapy Cryotherapy/ae [Adverse Effects] Human Laparotomy Liver Neoplasm Recurrence,Local/th [Therapy] Neuroendocrine Tumors/th [Therapy] Patient Selection surgery378-381*$British Journal of Hospital Medicine548Liver resection is the treatment of choice for resectable hepatic metastases; however, most patients have unresectable disease when diagnosed. Hepatic cryotherapy has been advocated to treat unresectable tumours in the liver although its precise role is still being evaluated. This article discusses mechanisms of action, technical considerations, current indications and the early results of cryotherapy in treating metastatic liver disease. [References: 26]hvoDB - MEDLINE UI - 96126721 IN - Department of Surgery, Otago University Medical School, Dunedin, New Zealand JC - bz5, 0171545 Journal Subset AIM Journals CP - England PT - Journal Article PT - Review PT - Review, Tutorial LG - English EM - 199602 Revised: 20001218. Entry Week: 199602 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0007-1064c& @  355ZTCryotherapy treatment of patients with hepatic metastases from neuroendocrine tumors(!Cozzi,P.J. Englund,R. Morris,D.L.d 19958/1/1995*Cryosurgery *Liver Neoplasms/sc [Secondary] *Neuroendocrine Tumors/sc [Secondary] Adenoma,Islet Cell/pa [Pathology] Adult Carcinoid Tumor/sc [Secondary] Carcinoid Tumor/su [Surgery] Case Report Cryotherapy Human Intestinal Neoplasms/pa [Pathology] Liver Liver Neoplasms/su [Surgery] Male methods Middle Age Morbidity Neuroendocrine Tumors Neuroendocrine Tumors/su [Surgery] Pancreatic Neoplasms/pa [Pathology] Paraganglioma/sc [Secondary] Paraganglioma/su [Surgery] surgery Syndrome United Stateso501-509U Cancer763yrkBACKGROUND. Liver metastases from neuroendocrine tumors often present with disabling symptoms due to syndromes of hormonal excess. A locally destructive technique such as hepatic cryotherapy not only alleviates symptoms but may improve survival in this group of patients. METHODS. Six patients with metastatic neuroendocrine tumors were treated with hepatic cryotherapy. Four patients were symptomatic and three of these had elevated tumor markers from ectopic hormone production. RESULTS. All patients are alive and asymptomatic, with a median follow-up of 24 months (range, 6 months to 6 years). All have had a complete radiologic response. All with elevated preoperative markers have had a greater than 89% decrease in tumor markers. Coagulopathy occurred in two patients necessitating additional surgery, but there was no other morbidity attributable to the cryotherapy. CONCLUSION. To the authors' knowledge, this study demonstrates for the first time that hepatic cryotherapy offers supportive treatment for patients with neuroendocrine tumors metastatic to the liver. Cryotherapy alleviates symptoms and may improve survivalu~xDB - MEDLINE UI - 96223056 IN - University Department of Surgery, University of New South Wales, St. George Hospital, Sydney, Australia JC - clz, CLZ, CLZ, 0374236 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199606 Revised: 20001218. Entry Week: 199606 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0008-543XSerum response of hepatocyte growth factor, insulin-like growth factor- I, interleukin-6, and acute phase proteins in patients with colorectal liver metastases treated with partial hepatectomy or cryosurgeryjdde Jong,K.P. von Geusau,B.A. Rottier,C.A. Bijzet,J. Limburg,P.C. de Vries,E.G. Fidler,V. Slooff,M.J. 2001 3/20014-Cryosurgery Hepatectomy Liver methods surgeryUI - 21219546 LA - eng PT - Journal Article DA - 20010426 IS - 0168-8278 SB - IM CY - Denmark JC - IBS RefMgr field[1]: Journal RefMgr field[8]: Not in File422-427 J.Hepatol.343@:BACKGROUND/AIMS: The aim of the study was to compare the serum response of regeneration factors and acute phase proteins in patients treated with partial hepatectomy or cryosurgery. METHODS: The responses of serum hepatocyte growth factor (HGF), insulin-like growth factor-I (IGF- I) (free and total), interleukin-6 (IL-6) and the acute phase proteins, C-reactive protein (CRP) and serum amyloid A (SAA) were examined in patients with colorectal liver metastases treated with partial hepatectomy (n = 14) or cryosurgery (n = 10). RESULTS: In both groups, IL-6 peak levels at the end of the operation were followed by peak levels at day 1 for HGF and CRP. SAA peak levels occurred on day 1 (hepatectomy group) and on day 4 (cryo group). The total HGF, IGF-I, and IL-6 responses were comparable in both groups. CRP and SAA responses were higher in the patients treated with cryosurgery than in patients after hepatectomy. Free IGF-I trough levels were lower in partial hepatectomy patients than in cryosurgery patients. CONCLUSIONS: In patients with colorectal liver metastases the responses of the regenerating factors HGF, IGF-I, and IL-6 are comparable to those in patients treated with partial hepatectomy. Upregulation of acute phase protein production is higher in patients after cryosurgery than in patients after partial hepatectomy'Department of Surgery, University Hospital and Medical Faculty of the University of Groningen, The Netherlands. k.p.de.jong@chir.azg.nl497 PM:11322204 444e& Experimental hepatic cryosurgery"Dutta,P. Montes,M. Gage,A.A. 197710/1977xq*Cryosurgery/mt [Methods] *Liver/su [Surgery] 7727-37-9 (Nitrogen) Alanine Transaminase/bl [Blood] Alkaline Phosphatase/bl [Blood] Animal Aspartate Transaminase/bl [Blood] Cryosurgery Cryosurgery/is [Instrumentation] Dogs EC 2-6-1-1 (Aspartate Transaminase) EC 2-6-1-2 (Alanine Transaminase) EC 3-1-3-1 (Alkaline Phosphatase) Liver/pa [Pathology] Nitrogen United States598-608 Cryobiology145 DB - MEDLINE UI - 78002710 JC - dt3, DT3, DT3, 0006252 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 197711 Revised: 20001218. Entry Week: 197711 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0011-2240ax  219.rlResection with cryotherapy of colorectal hepatic metastases has the same survival as hepatic resection alone81Finlay,I.G. Seifert,J.K. Stewart,G.J. Morris,D.L.r 2000 4/200082*Colorectal Neoplasms/pa [Pathology] *Cryosurgery *Hepatectomy *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] Adult Aged Aged,80 and over Cryotherapy Female Human Liver Liver Neoplasms/mo [Mortality] Male Middle Age Prognosis Retrospective Studies Support,Non-U.S.Gov't surgery Survival Rate199-202m,%European Journal of Surgical Oncologya263yBACKGROUND: Hepatic resection is well established as a potentially curative treatment for hepatic colorectal cancer metastases. However, only a small proportion of patients with liver metastases are suitable for resection because they either have extrahepatic disease, or the extent and/or the distribution of their hepatic disease would make excision impossible. We have previously described the use of cryotherapy for inadequate resection margins and lesions in the remaining lobe of the liver. Combining such cryodestructive techniques with resection offers the possibility of increasing the proportion of patients to whom potentially curative treatment can be offered. The aim of this study was to compare survival in patients treated with resection and cryotherapy against those of patients treated with resection alone. Potential prognostic variables were also examined. METHOD: Patients undergoing a hepatic resection with or without cryotherapy at our unit between April 1990 and July 1997 were identified from our database and their notes reviewed. Survival was estimated using the Kaplan-Meier method and compared using the Log rank test. RESULTS: One hundred and seven patients were treated in total: 32 underwent resection alone, and 75 underwent resection combined with cryotherapy. There was no significant difference between the survival of patients treated with resection alone and those treated with resection and cryotherapy. CONCLUSIONS: Edge and contralobe cryotherapy can be combined with hepatic resection to allow a greater proportion of patients with hepatic colorectal metastases to be offered treatment, and results in similar survival figures comparable to hepatic resection for at least 3 years. Copyright 2000 Harcourt Publishers LtdVODB - MEDLINE UI - 20218953 IN - The UNSW Dept of Surgery, St George Hospital, Sydney, Australia JC - eur, EUR, EUR, 8504356 Journal Subset Index Medicus CP - England PT - Journal Article LG - English EM - 20000518 Revised: 20001218. Entry Week: 20000518 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0748-7983  439.HADestruction of hepatic and splenic tissue by freezing and heating$Gage,A.M. Montes,M. Gage,A.A. 1982 4/1982*Freezing *Heat *Liver *Spleen Animal Cryosurgery Dogs Freezing Hemorrhage/th [Therapy] Liver/pa [Pathology] Necrosis Neoplasms/su [Surgery] Spleen/pa [Pathology] United States172-179 Cryobiology192 DB - MEDLINE UI - 82209778 JC - dt3, DT3, DT3, 0006252 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 198208 Revised: 20001218. Entry Week: 198208 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0011-2240i0*Mechanisms of tissue injury in cryosurgeryGage,A.A. Baust,J. 1998 1998ANIMAL-MODEL APOPTOSIS Cell Death CELLS cryoablation cryogens Cryosurgery Cryotherapy Freezing HEPATIC CRYOSURGERY ICE FORMATION injuries INTRACELLULAR ICE mechanisms PROSTATE-CANCER Temperature therapy tissue injury TUMOR171-186 Cryobiology373rkAs the modern era of cryosurgery began in the mid 1960s, the basic features of cryosurgical technique were established as rapid freezing, slow thawing, and repetition of the freeze-thaw cycle. Since then, new applications of cryosurgery have caused numerous investigations on the mechanism of injury in cryosurgery with the intent to better define appropriate or optimal temperature-time dosimetry of the freeze-thaw cycles. A diversity of opinion has become evident on some aspects of technique, but the basic tenets of cryosurgery remain unchanged. All the parts of the freeze-thaw cycle can cause tissue injury. The cooling rate should be as fast as possible, but it is not as critical as other factors. The coldest tissue temperature is the prime factor in cell death and this should be -50 degrees C in neoplastic tissue. The optimal duration of freezing is not known, but prolonged freezing increases tissue destruction. The thawing rate is a prime destructive factor and it should be as slow as possible. Repetition of the freeze-thaw cycle is well known to be an important factor in effective therapy. A prime need in cryosurgical research is related to the periphery of the cryosurgical lesion where some cells die and others live. Adjunctive therapy should influence the fate of cells in this region and increase the efficacy of cryosurgical techniques, (C) 1998 Academic PressevoJournal NOV 136RH CRYOBIOLOGY RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0011-2240p593 ISI:000076872600001r  293LFClinical experience with cryosurgery for advanced hepatobiliary tumorsB;Haddad,F.F. Chapman,W.C. Wright,J.K. Blair,T.K. Pinson,C.W.a 1998 3/1998*Bile Duct Neoplasms/su [Surgery] *Cryosurgery *Liver Neoplasms/su [Surgery] Adult Aged blood Blood Coagulation Disorders/et [Etiology] complications Cryosurgery Female Hemorrhage Human Liver Liver/su [Surgery] Male methods Middle Age Morbidity mortality Platelet Count Postoperative Complications/ep [Epidemiology] Postoperative Complications/mo [Mortality] surgery Survival Analysis United States Risk103-108D"Journal of Surgical Research752 INTRODUCTION: There have been reports that suggest cryosurgical techniques may be a useful adjunct to surgical resection or even a viable alternative treatment for hepatobiliary malignancies. Our objective was to evaluate the clinical results following cryoablation in conjunction with surgical resection for advanced hepatic tumors. MATERIALS AND METHODS: Thirty-two consecutive procedures in 31 patients with advanced liver tumors treated with cryosurgical ablation were evaluated. Cryosurgery was applied: (1) to achieve a > 1-cm tumor-free margin when standard surgical margins were close (2) with or without standard surgical resection to manage multiple tumors (3) with hepatic arterial portocath placement to increase tumor response. Cryoablation was applied to 47 of 105 lesions--independently in 4 patients and in combination with hepatic resection in 28 procedures. RESULTS: Cryoablation was used in 11 procedures because of close surgical margins. In 21 operations cryosurgery was used for primary ablation. In 17 of these 21 patients both cryosurgery and resection were used for different lesions; in 4 cryosurgery alone was used. Transient changes in hepatic enzymes, PT, PTT, and platelets were at maximum on Postoperative Days 1-3. Surgical mortality and morbidity rates were 6 and 60%, respectively. Coagulation abnormalities were common: at least 30% reduction in platelets occurred in all patients and greater than a 50% reduction occurred in 19 of 32 (59%). Twenty patients had a PT > 15 s and 6 of these 20 also had a platelet count < 50,000. Associated complications included one wound hematoma, two GI hemorrhages, one intracranial hemorrhage, and one hepatic hemorrhage from the cryosurgical site. The actuarial patient survivals were 90, 59, 33, and 22% at 6, 12, 24, and 36 months, respectively. CONCLUSIONS: This report helps define the risks and results of cryosurgical ablation as a complement to surgical resection for advanced hepatobiliary tumors. Management of lesions contiguous to major blood vessels may include either the Pringle maneuver or total vascular isolation. Since these procedures can have significant morbidity, we urge cautious application of cryosurgery for advanced hepatobiliary tumors in selected otherwise unresectable patients|DB - MEDLINE UI - 98319151 IN - Division of Hepatobiliary Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA JC - k7b, K7B, K7B, 0376340 Journal Subset Index Medicus CP - United States PT - Journal Article LG - English EM - 19980730 Revised: 20001218. Entry Week: 19980730 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0022-480494>7Realistic expectations for cryoablation of liver tumors Helling,T.S. 2000 2000jc*Cryosurgery *Liver Neoplasms/su [Surgery] Adult Aged Aged,80 and over complications Disease-Free Survival Female Follow-Up Studies Hepatectomy Human Incidence Length of Stay Liver Liver Neoplasms/sc [Secondary] Male Middle Age Neoplasm Recurrence,Local/ep [Epidemiology] Recurrence Risk Factors surgery Syndrome Time Factors Treatment Outcome Risk Safetys510-515a2,Journal of Hepato-Biliary-Pancreatic Surgery7n5i v pWhile cryoablation has been shown to be an effective method of destruction of primary and metastatic liver tumors, there is a disturbingly high incidence of recurrence at the cryoablated site and there are conflicting reports concerning long-term survival. For this reason, resection remains the preferred surgical treatment of liver tumors. However, there is a population of patients who, because of age, pre-existing liver disease, or likely systemic dissemination, present a higher risk for major resection, and for whom cryoablation may be favored. This study examined the safety and effectiveness of cryoablation in patients thought to be at higher risk for conventional hepatic resection, or in whom resection would not eradicate all known disease. Twenty-eight consecutive patients underwent cryoablation, with or without resection, of 39 hepatic tumors for primary (n = 9) or metastatic (n = 19) disease. Their postoperative course and long-term follow-up were examined for complications, survivability, and recurrence of disease. With the use of cryoablation, a major hepatic resection was avoided in 20 patients, 11 of whom were 70 years or older, 4 who likely had disseminated cancer even though the liver was the only site of detectable disease, 2 who were cirrhotic, and 2 with bilobar disease. An additional 7 patients had recurrence of disease in a previously resected liver, for whom additional resection would be hazardous. There was one operative death from an exaggerated systemic inflammatory response syndrome. Seven patients developed complications, including 2 patients with cryoablation-induced coagulopathy. Excluding 2 patients (including the postoperative death) the average hospital length of stay was 6.7 +/- 2.8 days. Seven patients required some intensive care unit (ICU) care. Three patients with primary liver cancer are alive 29 to 47 months after cryoablation. Two patients with metastatic disease are alive without recurrence at 12 and 16 months, and 9 are alive with disease from 13 to 58 months after cryoablation. Fifteen patients developed liver recurrence, 5/27 (19%) at the cryoablated site. Cryoablation appears to be a safe treatment modality for primary and metastatic liver cancer. It is particularly appealing in those patients who may be at higher risk for major hepatectomy because of age, pre-existing liver disease, type of metastatic disease, previous resection, or bilobar tumors. Most disturbing is the high incidence of recurrence at the cryoablated site, which may reflect problems with ultrasound localization or proximity of tumors to major vasculature. Disease-free survival is low. From this standpoint the procedure should be considered palliative, even though all hepatic tumors can be eradicated. However, these limitations should not deter the use of cryoablation in selected patients. There is the potential for long-term survival, just as there is with resectiontnDB - MEDLINE UI - 21111679 IN - Department of Surgery, University of Missouri-Kansas City, School of Medicine, 4320 Wornall Rd, Kansas City, Missouri 64111, USA JC - c53, c53 Journal Subset Index Medicus CP - Japan PT - Journal Article LG - English EM - 20010419. Entry Week: 20010419 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0944-1166 ^ 265JCLaparoscopic cryoablation of hepatic metastases. [Review] [51 refs]@:Heniford,B.T. Arca,M.J. Iannitti,D.A. Walsh,R.M. Gagner,M. 199810/1998m82*Cryosurgery/mt [Methods] *Laparoscopy/mt [Methods] *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] Cryosurgery Endosonography Feasibility Studies Human Liver Liver Neoplasms/mo [Mortality] Retrospective Studies surgery Surgical Procedures,Minimally Invasive/mt [Methods] United States Safety194-201$Seminars in Surgical Oncologya153XQCryosurgery for liver metastases may improve survival for unresectable hepatic metastases. The laparoscopic approach to managing these tumors is a novel method fostered by increasing surgeon and patient interest in minimally invasive surgical techniques and the development of laparoscopic ultrasound and cryoprobes. A retrospective review of our patients who underwent laparoscopic cryoablation of hepatic tumors from April 1996 to December 1997 was conducted. We report on this experience and comment on the feasibility and safety of the procedure based on this early trial. [References: 51]DB - MEDLINE UI - 98450912 IN - Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina 28232, USA JC - sso, SSO, SSO, 8503713 Journal Subset Index Medicus CP - United States PT - Journal Article PT - Review PT - Review, Tutorial LG - English EM - 19981221 Revised: 20001218. Entry Week: 19981221 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 8756-0437n 407ZSA comparative laboratory study of liquid nitrogen and argon gas cryosurgery systems0)Hewitt,P.M. Zhao,J. Akhter,J. Morris,D.L.  199712/1997a,%*Cryosurgery/is [Instrumentation] 7440-37-1 (Argon) 7727-37-9 (Nitrogen) Animal Argon Comparative Study Cryosurgery Cryosurgery/mt [Methods] Cryotherapy Evaluation Studies Freezing Human Ice Liver Liver/su [Surgery] Neoplasms/su [Surgery] Nitrogen Sheep surgery Temperature United States Waterd303-308r Cryobiologyy354oCryotherapy can now be applied using a variety of delivery systems and cryogens. We compared the Cryotech LCS 3000 liquid nitrogen system (Spembly, Andover, UK) with the CRYOcare argon gas-based system (Irvine, CA, U.S.A.) using three different 3-mm cryoprobes: an old liquid nitrogen probe (N-probe), a new N-probe featuring gas bypass and an argon gas probe. Each probe was tested in two models: (i) fresh sheep liver at 20 degrees C--the probe was inserted to a depth of 1.5 cm; the rate of ice ball formation was monitored by recording radial temperatures every 15 s at 5, 10, 15, and 20 mm from the cryoprobe, and the ice-ball diameter was measured every 2.5 min. After 10 min, the probe was warmed and the time taken until it could be extracted from the liver was recorded. (ii) Warm water bath--the probe was immersed in warm water (42 degrees C) for 15 min and the ice-ball diameter was measured at 5-min intervals. Radial temperatures in liver declined more rapidly (P < 0.001) and time to probe extraction was less (P < 0.01) when the argon gas system was used. The new N-probe performed better than its older counterpart, but was still slower than the argon gas system. In liver (20 degrees C), ice-ball diameters were similar after 10 min, but in warm water, they were larger when the new N-probe was used (P < 0.02). It would appear that the argon gas system is initially faster, but it does not achieve as large an ice ball in a warm environment as the liquid nitrogen systemA|vDB - MEDLINE UI - 98086845 IN - Department of Surgery, University of New South Wales, St. George Hospital, Kogarah, Sydney, Australia JC - dt3, DT3, DT3, 0006252 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199802 Revised: 20001218. Entry Week: 199802 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0011-2240 309`YMultiple bilobar liver metastases: cryotherapy for residual lesions after liver resection60Hewitt,P.M. Dwerryhouse,S.J. Zhao,J. Morris,D.L. 1998 2/1998xr*Colonic Neoplasms/pa [Pathology] *Cryotherapy *Hepatectomy *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] *Rectal Neoplasms/pa [Pathology] Adult Aged Cryotherapy Female Human Liver Liver Neoplasms/dt [Drug Therapy] Liver Neoplasms/mo [Mortality] Liver/pa [Pathology] Male methods Middle Age Morbidity Neoplasm,Residual surgery Survival Rate United States112-116g"Journal of Surgical Oncology672oBACKGROUND AND OBJECTIVES: Most patients with colorectal liver metastases are not eligible for resection because they have multiple lesions or because of anatomical constraints. We report the use of cryotherapy to destroy residual metastases following liver resection in patients with disease too widespread for treatment by resection alone. METHODS: Twenty patients with bilobar disease confined to the liver (median 3; range 2-8 lesions) were treated in this way. Seventeen patients also received regional chemotherapy postoperatively. RESULTS: Morbidity was high, but there were no procedure-related deaths and only one patient's hospital stay exceeded 24 days. Significant destruction of tumor, as evidenced by a decline in CEA levels, occurred within 3 months of surgery in all patients (P < 0.001). Median duration of follow-up was 15 (6-53) months. Survival rates at 1 and 2 years were 88% and 60%, respectively, and median survival was 32 months. Seven patients remain well and seven are alive with recurrent liver and/or other metastases. CONCLUSIONS: Although this is not a control study, it would appear that some patients with irresectable liver metastases benefit from this multimodality approachs{DB - MEDLINE UI - 98146187 IN - Department of Surgery, University of New South Wales, St. George Hospital, Kogarah, Sydney, Australia JC - k79, K79, K79, 0222643 Journal Subset Index Medicus CP - United States PT - Journal Article LG - English EM - 19980311 Revised: 20001218. Entry Week: 19980311 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0022-4790  ~18NHCT-monitored percutaneous cryoablation in a pig liver model: pilot studyNHLee,F.T.,Jr. Chosy,S.G. Littrup,P.J. Warner,T.F. Kuhlman,J.E. Mahvi,D.M. 1999 6/1999zs*Cryosurgery *Liver/su [Surgery] *Radiography,Interventional *Tomography,X-Ray Computed analysis Animal Cryosurgery/mt [Methods] Feasibility Studies Freezing Hemorrhage Ice Liver Liver/pa [Pathology] Liver/ra [Radiography] Liver/us [Ultrasonography] methods Necrosis Pilot Projects Punctures Support,Non-U.S.Gov't Swine Ultrasonography,Interventional United States Safety687-692r Radiologyo 211H3oPURPOSE: To determine the safety and feasibility of percutaneous cryoablation with computed tomographic (CT) guidance in a pig liver model. MATERIALS AND METHODS: Nine angiographic balloons (mean diameter, 9 mm) were placed in the livers of seven domestic pigs (mean weight, 30.0 kg +/- 14.0 [SD]) as tumor-mimicking lesions. By using ultrasonographic and CT guidance, two 2.4- or 3.0-mm cryoprobes were placed flanking the balloon, and a 15-20-minute freezing process was performed. Hemostasis was achieved by placing absorbable cellulose fabric down the probe tract. After 24-96 hours, animals were sacrificed, and their livers were removed and were sectioned axially at 5-mm intervals for comparison with CT images. RESULTS: All animals survived the procedure without complication. No serious hemorrhage was found in any case. Ice balls were readily visualized at CT because they appeared as areas of decreased attenuation (1.0 HU +/- 20.7) when compared with areas of normal liver (48.2 HU +/- 6.3, P < .05). The mean ablative margin was 1.7 cm, and only one of nine cases, the one with probe failure, had a positive margin. Beam-hardening artifact from the metal probes was present but did not interfere with the procedure. Ice-ball size and shape corresponded closely to the area of necrosis determined at histopathologic analysis. CONCLUSION: CT-monitored percutaneous cryoablation is feasible and safe in this pig liver modelxrDB - MEDLINE UI - 99280858 IN - Department of Radiology, University of Wisconsin, Madison 53792, USA. ftlee@facstaff.wisc.edu JC - qsh, QSH, QSH, 0401260 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 19990616 Revised: 20010323. Entry Week: 19990616 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0033-8419V ZTCha, C. Lee, F. T., Jr. Rikkers, L. F. Niederhuber, J. E. Nguyen, B. T. Mahvi, D. M.^WRationale for the combination of cryoablation with surgical resection of hepatic tumors*#Journal of Gastrointestinal Surgery 200152 206-13piAdult Aged Carcinoma, Hepatocellular/mo [Mortality] Carcinoma, Hepatocellular/su [Surgery] Colorectal Neoplasms/pa [Pathology] Cryosurgery/ct [Contraindications] *Cryosurgery Female Hepatectomy/ct [Contraindications] *Hepatectomy Human Liver Neoplasms/mo [Mortality] Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] Male Middle Age Survival Analysis ( "Only 5% to 10% of metastatic and primary liver tumors are amenable to surgical resection. Hepatic cryoablation has increased the number of patients who are suitable for curative treatment. The aim of this study was to evaluate survival and intrahepatic recurrence in patients treated with cryoablation and resection. From June 1994 to July 1999, thirty-eight surgically unresectable patients underwent a total of 42 cryoablative procedures for 65 malignant hepatic lesions. Twenty patients underwent cryoablation alone, and 18 patients were treated with a combination of resection and cryoablation, with a minimum of 18 months' follow-up. The 38 patients had the following malignancies: primary hepatocellular carcinoma (n = 8) and metastases from colorectal cancer (n = 21), neuroendocrine tumors (n = 3), ovarian cancer (n = 3), leiomyosarcoma (n = 1), testicular cancer (n = 1), and endometrial cancer (n = 1). Patients were evaluated preoperatively with spiral CT scans and intraoperatively with ultrasound examinations for lesion location and cryoprobe guidance. Local recurrence was detected by CT. Major complications included bleeding in three patients and acute renal failure, transient liver insufficiency, and postoperative pneumonia in one patient each. Two patients (5%) died during the early postoperative interval; mean hospital stay was 7.1 days. Median follow-up was 28 months (range 18 to 51 months). Overall survival according to Kaplan-Meier analysis was 82%, 65%, and 54% at 12, 24, and 48 months, respectively. Forty-eight-month survival was not significantly different between those patients undergoing cryoablation alone (64%) and those treated with a combination of resection and cryoablation (42%). Disease-free survival at 45 months was 36% for patients undergoing cryoablation plus resection compared to 25% for those undergoing cryoablation alone. Local recurrences were detected at five cryosurgical sites, for a rate of 12% overall (5 of 42), 11% (2 of 18) for patients in the cryoablation plus resection group, and 12% (3 of 24) for those in the cryoablation alone group. For patients with colorectal metastases, survival was 70% at 30 months compared to 33% for hepatocellular cancer and 66% for other types of tumors. Patients with tumors larger than 5 cm or numbering more than three did not have significantly decreased survival. Cryoablation of hepatic tumors is a safe and effective treatment for some patients not amenable to resection. The combination of cryoablation and resection results in survival comparable to that achieved with cryoablation alone. 425F@Development of a high-performance multiprobe cryosurgical device.(Chang,Z. Finkelstein,J.J. Ma,H. Baust,J. 1994 9/1994*Cryosurgery/is [Instrumentation] 7727-37-9 (Nitrogen) Animal Body Temperature Brain/su [Surgery] Cattle Cold Comparative Study Disposable Equipment Equipment Design Evaluation Studies Freezing Human Liver Liver Diseases/su [Surgery] Liver/su [Surgery] Male Miniaturization Nitrogen Nitrogen/ad [Administration & Dosage] Nitrogen/tu [Therapeutic Use] Pressure Prostatic Neoplasms/su [Surgery] Support,U.S.Gov't,P.H.S. Surface Properties Temperature United States ProstateP383-390/.'Biomedical Instrumentation & Technologyi285 The authors describe the design of the first multiprobe cryosurgical system (AccuProbe system). Compared with prior conventional cryosurgical devices, the new system has the following characteristics: 1) generation of subcooled liquid nitrogen, 2) optional use of up to five independently operated and controlled cryoprobes, 3) use of disposable probes of various sizes and shapes, 4) more accurate placement of the cryoprobes in the lesions due to probe miniaturization (3.4 mm in overall diameter), and 5) higher capacity freezing, which supports more accurate and controllable tissue temperatures. With the use of the newly developed system, numerous cryosurgical procedures, including those in the prostate, brain, and liver, have been successfully performedRLDB - MEDLINE UI - 95093488 IN - Cryomedical Sciences, Inc., Rockville, MD 20850 JC - bti, 8905560 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English NO - R43CA58052 (NCI) EM - 199501 Revised: 20001218. Entry Week: 199501 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0899-8205 6 423PJUltrasonographic characterization of hepatic cryolesions. An ex vivo study& Lam,C.M. Shimi,S.M. Cuschieri,A. 199510/1995a*Cryosurgery *Liver/us [Ultrasonography] 7647-14-5 (Sodium Chloride) Animal Cryopreservation/mt [Methods] Cryotherapy Crystallization Elasticity Electric Impedance Freezing Ice Ice/an [Analysis] In Vitro Liver Liver Neoplasms/su [Surgery] Liver/pp [Physiopathology] Liver/su [Surgery] Nitrogen Reference Values Sodium Chloride/ch [Chemistry] surgery Swine Temperature United States WaterS 1068-1072BArchives of SurgeryI 130t10lfOBJECTIVE: To determine the physical basis for the ultrasonographic characteristics of the hepatic ice ball produced by cryotherapy and the size correlation between the actual hepatic ice ball and the ultrasonographic cryolesion. DESIGN: Experimental ex vivo study involving controlled freezing with liquid nitrogen recirculating probes of fresh porcine livers immersed in various solutions at ambient temperatures (20.2 degrees C to 22.6 degrees C), together with measurements of the impedance of frozen and unfrozen liver. RESULTS: First, the hyperechoic rim is caused by reflection of 34% of ultrasound waves at the interface between unfrozen and frozen liver as a consequence of an increased acoustic impedance of frozen liver that was calculated to be approximately 3.8 times that of unfrozen liver tissue. The increased acoustic impedance is due to the decrease in elasticity of hepatic tissue as it freezes. Second, the posterior acoustic shadowing is partly due to the attenuation of the incident ultrasound waves by reflection at the interface between unfrozen and frozen liver. It is also dependent on the crystalloid-protein content of hepatic parenchyma, which ensures a homogeneous lesion by preventing "shattering" within the cryolesion. This is in sharp contrast to the ultrasonographic appearance of an ice ball formed in ionized water, in which the hyperechoic rim overlies an area of posterior acoustic enhancement. Third, the correlation of the size between the ultrasonographic cyrolesion and the measured hepatic ice ball approached unity (r = .99), and the two measurements were identical for cryolesions less than 50 mm in diameter. CONCLUSION: Ultrasound is an accurate method for depicting the actual diameter of frozen solid hepatic tissue in cryotherapy for liver tumors, but the present technology does not provide accurate assessments of the volume of frozen tissuejdDB - MEDLINE UI - 96045560 IN - Department of Surgery, University of Dundee (Scotland), Ninewells Hospital and Medical School JC - 8ia, 9716528 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199511 Revised: 20001218. Entry Week: 199511 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0004-0010NGNeedle Implantation Cryoprobes: Biophysical and Thermal CharacteristicsLam,C.M. Shimi,S.M. 1997 6/1997("Cryosurgery Freezing Liver surgeryUI - 0 LA - ENG PT - JOURNAL ARTICLE DA - 19990712 IS - 1071-5517 SB - IM JC - C1X RefMgr field[1]: Journal RefMgr field[8]: Not in File 89-95iSemin.Laparosc.Surg.4 2aThere has been increased recent interest in hepatic cryosurgery for primary and metastatic tumors in the liver. This has been realized through technological advances in intraoperative ultrasound monitoring and cryoprobe technology. Purpose-designed needle implantable cryoprobes have been developed to freeze deep-seated tumors in the hepatic parenchyma. However, the biophysical and thermal characteristics of these implantable cryoprobes have not been studied. This article discusses the biophysical and thermal characteristics of recently developed high-efficiency, implantable needle cryoprobes that can be used laparoscopically. The cryolesion was formed along the whole length of the cryoprobe implanted into hepatic tissue. It was cylindrical in shape and extended 8 mm beyond the tip of the cryoprobe after 20 minutes of freezing. During this period of freezing, the volume of the cryolesion increased in a near constant manner, but the diameter increased in a logarithmic fashion. In addition, single-cycle freezing produced a larger cryolesion than a dual freeze cycle interrupted by a 5-minute thaw. Further, increasing the length of cryoprobe implantation increased the volume of the cryolesion, although the diameter was smaller. The rate of cooling at the tip of the cryoprobe was also faster with partial implantation of the cryoprobe than with complete implantation. The cooling rate varied vertically along the length of the cryoprobe, as well as horizontally from the cryoprobea'D=Department of Surgery, University of Dundee, Dundee, Scotlandi513 PM:10401145TC 304*$Cryotherapy for primary liver cancerZhou,X.D. Tang,Z.Y. 1998 3/1998LE*Cryotherapy *Liver Neoplasms/su [Surgery] Adult Aged complications Cryotherapy Cryotherapy/mt [Methods] Female Follow-Up Studies Freezing Hepatic Artery Human Life Tables Ligation Liver Male Middle Age mortality Nitrogen Perfusion Retrospective Studies Support,Non-U.S.Gov't Survival Analysis Treatment Outcome United States171-174$Seminars in Surgical Oncology142Between November 1973 and December 1996, the in situ freezing of tumor, i.e., cryotherapy, was performed with liquid nitrogen (-196 degrees C) on 235 patients with primary liver cancer (PLC). There were no operative mortalities or severe complications. The 5-year survival was 39.8% for the 235 PLC patients, and 55.4% for the 80 patients with small PLC (< or = 5 cm). When analyzed with respect to treatment modalities without considering the size of the tumor, the 5-year survival was 26.9% for 78 PLC patients treated by cryotherapy alone; 39.6% for 58 PLC patients treated by cryotherapy plus hepatic artery ligation and perfusion; 46.0% for 27 PLC patients treated by cryotherapy for residual tumor plus resection of the main tumor; and 60.4% for 72 PLC patients treated by cryotherapy followed by resection of the frozen tumor. These results indicate that cryotherapy is a safe and effective treatment for PLCazDB - MEDLINE UI - 98153907 IN - Liver Cancer Institute, Zhong Shan Hospital, Shanghai Medical University, People's Republic of China JC - sso, SSO, SSO, 8503713 Journal Subset Index Medicus CP - United States PT - Journal Article LG - English EM - 19980312 Revised: 20001218. Entry Week: 19980312 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 8756-0437 Z 361rkThrombocytopenia after hepatic cryotherapy for colorectal metastases: correlates with hepatocellular injuryd*#Cozzi,P.J. Stewart,G.J. Morris,D.L.d 1994 9/1994>7*Colorectal Neoplasms/pa [Pathology] *Cryotherapy/ae [Adverse Effects] *Liver Neoplasms/th [Therapy] *Liver/pa [Pathology] *Thrombocytopenia/et [Etiology] Cryotherapy Female Human injuries Laparotomy Liver Neoplasms/sc [Secondary] Male Platelet Count Retrospective Studies surgery United States Thrombocytopenia 774-776eWorld Journal of Surgery185aPostoperative thrombocytopenia following hepatic cryotherapy has been well documented and shown to be significantly greater than in control patients who had an identical incision or major laparotomy. Serum aspartate transaminase (AST) levels have been used as a reliable indicator of hepatocellular destruction. This study reviews 65 consecutive hepatic cryotherapy operations. We have excluded all patients who had repeat cryotherapy to lesions (n = 6), all who had a colonic or hepatic resection procedure (n = 7), all who had tumors other than colorectal metastases (n = 5), patients with inadequate data (n = 9), and those who were asplenic (n = 2). Of the remaining 36 patients, 14 were treated with a single freeze/thaw cycle, 12 were treated with a double freeze/thaw cycle, and 10 were treated with mixed single and double freezes. The most common platelet nadir was day 3 (n = 21) followed by day 2 (n = 11), with the remaining platelet nadirs being day 1 or 4 (n = 4). The percentage fall in platelet count was found to correlate with the rise in day 1 AST level (r2 = 0.74, least squares linear regression). The double freeze/thaw cycle patients had a significantly greater fall in platelet count (p = 0.01, Mann-Whitney two sample test). Another institution has reported three deaths due to multiple problems, including coagulopathy in patients treated with double freeze/thaw cycle cryotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)|vDB - MEDLINE UI - 95066167 IN - University of New South Wales, Department of Surgery, St. George Hospital, Kogarah, Sydney, Australia JC - xo8, XO8, XO8, 7704052 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199412 Revised: 20001218. Entry Week: 199412 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0364-2313)&'|(L24Hepatic cryosurgery3$Ravikumar,T.S. Steele,G.D.,Jr. 1989 4/1989NG*Cryosurgery/mt [Methods] *Liver Neoplasms/su [Surgery] Adult Aged Cryosurgery Female Freezing Human Liver Liver Neoplasms/di [Diagnosis] Liver Neoplasms/sc [Secondary] Liver/pa [Pathology] Male Middle Age Necrosis Neuroendocrine Tumors Nitrogen Recurrence Safety surgery Tomography,X-Ray Computed Ultrasonography United States433-440(!Surgical Clinics of North America692Cryoablation of liver metastases from colorectal and neuroendocrine tumors was accomplished in 20 patients using liquid nitrogen delivered through insulated probes. Intra-operative ultrasound was used to detect liver metastases and to monitor freezing and thawing. Tumor response was evaluated by histologic examination, CT, and serum tumor markers. This study established the safety and technical feasibility of hepatic cryosurgery and provided guidelines for treating liver tumors of diverse origins^WDB - MEDLINE UI - 89187319 IN - Department of Surgery, New England Deaconess Hospital, Boston, Massachusetts JC - van, 0074243 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 19890421 Revised: 20010323. Entry Week: 19890421 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0039-610923D>A 5-year study of cryosurgery in the treatment of liver tumorsHARavikumar,T.S. Kane,R. Cady,B. Jenkins,R. Clouse,M. Steele,G.,Jr.t 199112/19910XQ*Cryosurgery/mt [Methods] *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] Adult Aged Aged,80 and over Cryosurgery Female Follow-Up Studies Human Laparotomy Length of Stay Liver Liver Neoplasms/mo [Mortality] Male Middle Age Nitrogen Postoperative Complications Recurrence surgery Survival Rate Ultrasonography United States 1520-1523Archives of Surgery 126812This report summarizes our 5-year experience with cryosurgery for in situ ablation of liver tumors. The liver was exposed with laparotomy, and the tumors were subjected to two freeze-thaw cycles using liquid nitrogen delivered by insulated probes; cryoablation was monitored with intraoperative ultrasonography. Tumor markers and computed tomography evaluated tumor response during long-term follow-up. From 1985 to 1990, 32 patients (19 men and 13 women) were entered into this study. The histologic characteristics of the tumors were as follows: colorectal, 24 patients; hepatoma, three patients; neuroendocrine, two patients; and others, three patients. After a follow-up period of 5 to 60 months (median follow-up, 24 months), nine patients (28%) remained disease free, 11 patients (34%) were alive with disease, and 12 patients (38%) died. The patterns of failure included liver and extrahepatic disease in 54% of cases, liver disease only in 32% of cases, and extrahepatic disease only in 14% of cases. In patients with "liver only" failure, recurrence at the treatment site occurred in three patients (9%). This study establishes the long-term effectiveness of cryosurgery in the treatment of primary and metastatic liver tumorso`YDB - MEDLINE UI - 93074366 IN - Department of Surgery, Yale University School of Medicine, New Haven, CT 06510 JC - 8ia, 9716528 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 19921203 Revised: 20010323. Entry Week: 19921203 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0004-0010  416b\Surgical management of colorectal metastases to the liver: role of resection and cryosurgery<5Redlich,P.N. Baker,E.J. McAuliffe,T.L. Quebbeman,E.J.1 199612/1996XR*Colorectal Neoplasms/pa [Pathology] *Liver Neoplasms Aged analysis Colorectal Neoplasms/th [Therapy] Cryosurgery Cryosurgery/mt [Methods] Female Follow-Up Studies Human Liver Liver Neoplasms/sc [Secondary] Liver Neoplasms/su [Surgery] Liver/su [Surgery] Male Middle Age mortality Multivariate Analysis surgery Survival Rate United States859-863  Wisconsin Medical JournalI9512yLong-term results of 41 patients who underwent hepatic resection and early experience with 21 patients treated by hepatic cryosurgery alone or combined with resection for colorectal metastases are presented. Patients treated by resection had three or fewer metastases, no perioperative mortality, and a mean follow-up of 43.5 months. The five-year overall survival is 34% with a median survival of 48 months. By multivariate analysis, only transfusions correlated significantly with survival, but in a negative manner (p = 0.05). A mean of 4.3 units were transfused per patient, though only 25 patients actually received transfusionsF?DB - MEDLINE UI - 97146365 IN - Department of Surgery, Medical College of Wisconsin, USA JC - xpj, 0110663 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199702 Revised: 20001218. Entry Week: 199702 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0043-6542a 438.'The use of CT in monitoring cryosurgery4-Reiser,M. Drukier,A.K. Ultsch,B. Feuerbach,S. 1983 5/1983*Cryosurgery *Tomography,X-Ray Computed Animal Cryosurgery Cryosurgery/is [Instrumentation] Cryosurgery/mt [Methods] Ice Kidney/su [Surgery] Liver/su [Surgery] Swine Temperaturey123-128$European Journal of Radiology32sOne of the main problems encountered in cryosurgery is that of controlling the amount of tissue that is irreversibly destroyed by cooling. In vitro-experiments in which the homogeneous cooling of various substances, as well as "ice-ball" propagation within different tissues of animals via a cryotip were evaluated. In vivo experiments, on an anaesthetized pig, indicate CT to be a useful continuous-monitoring technique with a high spatial resolution. Using CT simultaneous localization of pathological tissue and measurement of temperature distribution is possible. The density changes induced by cooling were visualized on CT and the corresponding temperature changes were measured using thermocouples. The greatest decrease in density was observed as a change of phase took place. The speed of ice-ball propagation as well as the diameter of the ice ball generated varied considerably depending on the type of tissue. Construction of cryoprobes of a very small diameter could facilitate the percutaneous treatment of lesions within the body DB - MEDLINE UI - 83261900 JC - em6, EM6, EM6, 8106411 Journal Subset AIM Journals CP - Germany, West PT - Journal Article LG - English EM - 198309 Revised: 20001218. Entry Week: 198309 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0720-048X  7727-37-9 (Nitrogen)t Acute DiseaseAdenocarcinomaAdenocarcinoma/surgery$!Adenoma,Islet Cell/pa [Pathology] AdolescenceAdultadverse effects Age FactorsAgedtAged, 80 and overAged,80 and over/$Alanine Transaminase/bl [Blood]]r$Alkaline Phosphatase/bl [Blood]]r analysis(Analysis of Variance Animalne  ANIMAL-MODELAntigen-Antibody Complexl$Antigens,Neoplasm/an [Analysis] APOPTOSISArgonARTERIAL FLOXURIDINEAsia/epidemiology$!Aspartate Transaminase/bl [Blood] AustraliaAustralia/epidemiology$ Autoantibodies/bi [Biosynthesis],&Bacterial Infections/ep [Epidemiology] Bile Ducts Biliary Fistula/et [Etiology]Bilirubin/bl [Blood]sBiological Markers Biopsy biosynthesisblood,(Blood Coagulation Disorders/epidemiology,)Blood Coagulation Disorders/et [Etiology]$Blood Proteins/me [Metabolism],Ad blood supplyBody TemperaturegBrain/su [Surgery]n)tBreast Neoplasms CANCERCapillary Permeability].H,&Capillary Permeability/ph [Physiology]t [Carcinoembryonic Antigen(#Carcinoembryonic Antigen/bl [Blood]$Carcinoid Tumor/sc [Secondary]gy] Carcinoid Tumor/su [Surgery]y CARCINOMA,(Carcinoma, Hepatocellular/mo [Mortality]<6Carcinoma, Hepatocellular/mortality/secondary/*therapy0+Carcinoma, Hepatocellular/mortality/surgery,&Carcinoma, Hepatocellular/su [Surgery](#Carcinoma,Hepatocellular/bl [Blood]]y,'Carcinoma,Hepatocellular/mo [Mortality],'Carcinoma,Hepatocellular/pa [Pathology]y](%Carcinoma,Hepatocellular/su [Surgery](%Carcinoma,Hepatocellular/th [Therapy] Case Reportum,&Catheter Ablation/is [Instrumentation]$Catheter Ablation/mt [Methods] Catheterization,Peripheral Cattlesu Cause of Death Cell Death Cell DivisionCell PhysiologyCELLSChemotherapy,AdjuvantClinical TrialsColdlColonic Neoplasms$ Colonic Neoplasms/sc [Secondary]colorectal cancer colorectal hepatic metastasesColorectal Neoplasms(#Colorectal Neoplasms/mo [Mortality]41Colorectal Neoplasms/mortality/pathology/*therapy(#Colorectal Neoplasms/pa [Pathology]$Colorectal Neoplasms/pathology$!Colorectal Neoplasms/th [Therapy]COLORECTAL-CANCERCombined Modality TherapyComparative Study complicationsCreatinine/bl [Blood] cryoablations cryogens Cryopreservation/mt [Methods] Cryosurgeryon Cryosurgery/*adverse effects<8Cryosurgery/*adverse effects/statistics & numerical dataCryosurgery/*methods(#Cryosurgery/adverse effects/methods$ Cryosurgery/ae [Adverse Effects]("Cryosurgery/ct [Contraindications]$ Cryosurgery/is [Instrumentation] Cryosurgery/mo [Mortality]Cryosurgery/mt [Methods]CRYOSURGICAL ABLATION Cryotherapybl($Cryotherapy/adverse effects/*methods$ Cryotherapy/ae [Adverse Effects]Cryotherapy/mt [Methods]CrystallizationDatabases,Factual DETERMINANTS diagnosisDisease Models,AnimalDisease-Free SurvivalDisposable Equipmentt,&Disseminated Intravascular Coagulation83Disseminated Intravascular Coagulation/epidemiologyDogs(#EC 2-6-1-1 (Aspartate Transaminase)og$!EC 2-6-1-2 (Alanine Transaminase)$!EC 3-1-3-1 (Alkaline Phosphatase) ElasticityElectric Impedance ElectrodesEndosonography($Endothelium, Vascular/pa [Pathology] Endothelium/pa [Pathology] epidemiologyEquipment Designm etiology-Europe/epidemiologyEvaluation Studiesntt Eye NeoplasmsFeasibility Studies Femalerge,)Fluorouracil/ad [Administration & Dosage]Follow-Up Studies Formaldehyde Freezing-Gastrinoma/su [Surgery] Gastrointestinal Neoplasms,'Gastrointestinal Neoplasms/su [Surgery](#Gonadorelin/administration & dosage Guinea PigsieHeat Hemodynamicsr HemorrhageHemorrhage/etiologyHemorrhage/th [Therapy] Hepatectomy(A Hepatectomy/*adverse effects$ Hepatectomy/ae [Adverse Effects]i, * + 3226/Infectious complications of hepatic cryosurgeryB