Kidney carboxycryoablation. Pilot study


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim: The aim of this experimental study was to evaluate the effect of low temperatures of carbon dioxide on a “living” blood-supplying organ (pig kidney), to determine the possibility of performing cryoablation of kidney tissue with carbon dioxide (carboxycryoablation), as well as to establish experimentally modes of carboxycryoablation of the kidney. Materials and methods. To carry out this experimental study, a female of the mini-pig line was used. We performed laparoscopic access to the kidney for carboxycryoablation. During the freezing of the kidney, three modes were compared: 60, 90, and 120 s on one kidney of one animal. Immediately after the completion of cryoablation, nephrectomy was performed, and the removed kidney was sent for histological examination. According to the histological study, the results of the use of carbon dioxide during cryoablation of porcine kidney tissue were evaluated. Results. Cryoablation based on carbon dioxide (carboxycryoablation) leads to irreversible death (necrosis) and destruction of the affected tissue. A direct relationship between the exposure mode and the size of the cryonecrosis zone was noted. Thus, the most extensive zone of necrosis with a diameter of 10 mm was achieved when performing cryoablation in the exposure mode of 120 s. Conclusion. This experiment showed that carbon dioxide-based cryoablation remains a feasible procedure that leads to irreversible death (necrosis) and destruction of the affected tissue. However, further studies on the safety and efficacy of cryoablation of kidney tissue with carbon dioxide are required.

Full Text

Restricted Access

About the authors

A. D Damiev

I.M. Sechenov First Moscow State Medical University

Email: damievakhmed@mail.ru
Ph.D. student at the Institute for Urology and Human Reproductive Health

G. N Akopyan

I.M. Sechenov First Moscow State Medical University

Email: docgagik@mail.ru
urologist, MD, Ph.D., professor of the Institute of Urology and Reproductive Health

E. V Spot

I.M. Sechenov First Moscow State Medical University

Email: shpot@inbox.ru
urologist, professor, Ph.D., MD, Head of the Department of Oncourology of Institute of Urology and Reproductive Health

R. R Kharchilava

I.M. Sechenov First Moscow State Medical University

Email: dr.revaz@gmail.com
urologist, Ph.D., Director of the “Praxi Medica” Medical Practice Training Center

M. A Kodzokov

I.M. Sechenov First Moscow State Medical University

Email: kodzokov-m@mail.ru
Ph.D. student Institute of Urology and Reproductive Health

E. N Gasanov

I.M. Sechenov First Moscow State Medical University

Email: elmar.gasanow2017@yandex.ru
Ph.D. student at the Institute of Urology and Reproductive Health

Yu. V Lerner

I.M. Sechenov First Moscow State Medical University

Email: julijalerner@inbox.ru
pathologist, assistant at the Department of Pathology named after A.I. Strukov

M. M Krivov

Pirogov Russian National Research Medical University

6-year student of Pediatric Faculty

M. A Gazimiev

I.M. Sechenov First Moscow State Medical University

Email: gazimiev@yandex.ru
urologist, professor, Deputy Director on Academic Affair of the Institute for Urology and Human Reproductive Health

References

  1. Neel H.B. Cryosurgery for the treatment of cancer. Laryngoscope. 1980; 90(8 Pt 2):1-48. doi: 10.1288/00005537-198008001-00001.
  2. Patel B.C., Parsons C.L., Bidair M., Schmidt J.D. Cryoablation for carcinoma of the prostate. Journal of Surgical Oncology. 1996;63(4):256-264. doi: 10.1002/(SICI)1096-9098(199612)63:4<256:AID-JS08>3.0.C0;2-B.
  3. Rowbotham G.F., Haigh A.L., Leslie W.G. Cooling cannula for use in the treatment of cerebral neoplasms. Lancet. 1959; 273(7062): 12-15. doi: 10.1016/S0140-6736(59)90976-6.
  4. EAU Guidelines: Prostate Cancer | Uroweb. https://uroweb.org/guideline/prostate-cancer/#6 (accessed Nov. 25, 2020).
  5. Melodie Vander Borght, Christine Wyns. Clinically Localized Prostate Cancer:AUA/ASTR0/SU0 Guideline. Part II: Recommended Approaches and Details of Specific Care Options. J. Urol. 2018; 199(4)990-997. doi: 10.1016/J.JUR0.2018.01.002.
  6. Campbell S. et al. Renal Mass and Localized Renal Cancer: AUA Guideline. J Urol 2017;198(3):520-529. doi: 10.1016/J.JUR0.2017.04.100.
  7. Long J.P., Faller G.T. Percutaneous cryoablation of the kidney in a porcine model. Cryobiology. 1999;38(1):89-93. doi: 10.1006/cryo.1999.2150.
  8. Young J.L. et al. 0ptimal freeze cycle length for renal cryotherapy. J. Urol. 2011;186(1):283-288. doi: 10.1016/J.JUR0.2011.03.034.
  9. Brashears J.H. 3rd et al. Renal cryoablation and radio frequency ablation: an evaluation of worst case scenarios in a porcine model. J Urol. 2005; 173(6):2160-2165. doi: 10.1097/01.JU.0000158125. 80981.F1.
  10. Schumann C. et al. Endobronchial tumor debulking with a flexible cryoprobe for immediate treatment of malignant stenosis. J. Thorac. Cardiovasc. Surg. 2010;139(4):997-1000. doi: 10.1016/J.JTCVS.2009.06.023.
  11. Hetzel J. et al. Cryobiopsy increases the diagnostic yield of endobronchial biopsy: a multicentre trial. Eur. Respir. J. 2012 39(3):685-690. doi: 10.1183/09031936.00033011.
  12. Fruchter O., Kramer M.R. Retrieval of various aspirated foreign bodies by flexible cryoprobe: in vitro feasibility study. Clin. Respir. J. 2015;9(2):176- 179. doi: 10.1111/CRJ.12120.
  13. Tomic R., Podgaetz E., Andrade R.S., Dincer H.E. Cryotechnology in diagnosing and treating lung diseases. J. Bronchology Interv. Pulmonol. 2015;22(1):76-84. doi: 10.1097/LBR.0000000000000103.
  14. Vergnon J.M., Huber R.M., Moghissi K. Place of cryotherapy, brachytherapy and photodynamic therapy in therapeutic bronchoscopy of lung cancers. Eur. Respir. J. 2006;28(1):200-218. doi: 10.1183/09031936.06.00014006.
  15. Lee S.H. et al. Endoscopic cryotherapy of lung and bronchial tumors: a systematic review. Korean J.Intern. Med. 2011;26(2):137-144. doi: 10.3904/KJIM.2011.26.2.137.
  16. Lentz R.J. et al. Transbronchial cryobiopsy for diffuse parenchymal lung disease: a state-of-the-art review of procedural techniques, current evidence, and future challenges. J. Thorac. Dis. 2017;9(7):2186-2203. doi: 10.21037/JTD.2017.06.96.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies