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Title: $In Vitro, Ex Vivo and In Vivo Isotherms for Renal Cryotherapy
Abstract: No AccessJournal of UrologyInvestigative Urology1 Feb 2010In Vitro, Ex Vivo and In Vivo Isotherms for Renal Cryotherapyis companion ofUnintended Consequences of Laparoscopic Surgery on Partial Nephrectomy for Kidney Cancer Jennifer L. Young, Surendra B. Kolla, Donald L. Pick, Petros Sountoulides, Oskar G. Kaufmann, Cervando G. Ortiz-Vanderdys, Victor B. Huynh, Adam G. Kaplan, Lorena A. Andrade, Kathryn E. Osann, Michael K. Louie, Elspeth M. McDougall, and Ralph V. Clayman Jennifer L. YoungJennifer L. Young , Surendra B. KollaSurendra B. Kolla , Donald L. PickDonald L. Pick , Petros SountoulidesPetros Sountoulides , Oskar G. KaufmannOskar G. Kaufmann , Cervando G. Ortiz-VanderdysCervando G. Ortiz-Vanderdys , Victor B. HuynhVictor B. Huynh , Adam G. KaplanAdam G. Kaplan , Lorena A. AndradeLorena A. Andrade , Kathryn E. OsannKathryn E. Osann , Michael K. LouieMichael K. Louie , Elspeth M. McDougallElspeth M. McDougall , and Ralph V. ClaymanRalph V. Clayman View All Author Informationhttps://doi.org/10.1016/j.juro.2009.09.072AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Preoperative planning for renal cryotherapy is based on isotherms established in gel. We replicated gel isotherms and correlated them with ex vivo and in vivo isotherms in a porcine model. Materials and Methods: PERC-17 CryoProbes™ (1.7 mm) and IceRods™ (1.47 mm) underwent trials in gel, ex vivo and in vivo porcine kidneys. Temperatures were recorded at 13 predetermined locations with multipoint thermal sensors. Results: At the cryoprobe temperatures were not significantly different along the probe in any medium for either system (p = 0.0947 to 0.9609). However, away from the probe ex vivo and in vivo trials showed warmer temperatures toward the cryoprobe tip for each system (p = 0.0003 to 0.2141). Mean ± SE temperature 5 mm distal to the cryoprobe tip in vivo was 19.2C ± 16.1C for CryoProbes and 27.3C ± 11.2C for IceRods. Temperatures were consistently colder with CryoProbes than with IceRods in gel (p <0.00005), ex vivo (p <0.00005) and in vivo (p = 0.0014). At almost all sites temperatures were significantly colder in gel and in ex vivo kidney than in in vivo kidney for CryoProbes (p = 0.0107 and 0.0008, respectively) and for IceRods (each p <0.00005). Conclusions: Gel and ex vivo isotherms do not predict the in vivo pattern of freezing. Thus, they should not be used for preoperative planning. The cryoprobe should be passed 5 mm beyond the tumor border to achieve suitably cold temperatures. Multipoint thermal sensor probes are recommended to record actual temperature during renal cryotherapy. References 1 : Global increases in kidney cancer incidence, 1973–1992. Eur J Cancer Prev2002; 11: 171. Google Scholar 2 : The natural history of incidentally detected small renal masses. Cancer2004; 100: 738. Google Scholar 3 : Independent validation of the 2002 American Joint Committee on Cancer primary tumor classification for renal cell carcinoma using a large, single institution cohort. J Urol2005; 173: 1889. Link, Google Scholar 4 : The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol2006; 175: 425. Link, Google Scholar 5 : Watchful waiting for solid renal masses: insight into the natural history and results of delayed intervention. J Urol2007; 177: 466. Link, Google Scholar 6 : Renal cryotherapy: a detailed review including a 5-year follow-up. BJU Int2007; 99: 1265. Google Scholar 7 : Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review. J Urol2008; 179: 1227. Link, Google Scholar 8 : Laparoscopic renal cryoablation: oncologic outcomes at 5 years. J Endourol2006; 20: A12. abstract. Google Scholar 9 : A pig model of hepatic cryotherapy: In vivo temperature distribution during freezing and histopathological changes. Cryobiology2003; 47: 214. Google Scholar 10 : Cryosurgical effects on growing vessels. Am Surg1999; 65: 677. Google Scholar 11 : Numerical solution of multidimensional freezing problem during cryosurgery. ASME-JBME1998; 120: 32. Google Scholar 12 : Rate of lesion growth around spherical and cylindrical cryoprobes. Cryobiology1971; 7: 183. Google Scholar 13 : Cryosurgical changes in the porcine kidney: histologic analysis with thermal history correlation. Cryobiology2002; 45: 167. Google Scholar 14 : Effect of freezing parameters (freeze cycle and thaw process) on tissue destruction following renal cryoablation. J Endourol2002; 16: 519. Google Scholar 15 : Effect of freeze time during renal cryoablation: a swine model. J Endourol2006; 20: 1101. Google Scholar 16 : In vivo efficacy of laparoscopic assisted percutaneous renal cryotherapy: evidence based guidelines for the practicing urologist. J Urol2008; 179: 333. Link, Google Scholar 17 : Precised characterization of renal parenchymal response to single and multiple cryoablation probes. J Urol2006; 176: 784. Link, Google Scholar 18 : An assessment of tumor cell viability after in vitro freezing. Cryobiology1985; 22: 417. Google Scholar 19 : Percutaneous cryosurgery for renal tumors. Br J Urol1995; 75: 132. Google Scholar 20 : Monitoring renal cryosurgery: predictors of tissue necrosis in swine. J Urol1998; 159: 1370. Link, Google Scholar 21 : Renal cryosurgery: experimental evaluation of treatment parameters. Urology1998; 52: 29. Crossref, Medline, Google Scholar 22 : Mechanisms of tissue injury in cryosurgery. Cryobiology1998; 37: 171. Google Scholar 23 : Measurement and prediction of thermal behavior and acute assessment of injury in a pig model of renal cryosurgery. J Endourol2001; 15: 193. Google Scholar 24 : Temperature measurements of the low-attenuation radiographic ice ball during CT-guided renal cryoablation. Cardiovasc Intervent Radiol2008; 31: 116. Google Scholar University of California-Irvine, Orange, California© 2010 by American Urological AssociationFiguresReferencesRelatedDetailsRelated articlesJournal of Urology14 Dec 2009Unintended Consequences of Laparoscopic Surgery on Partial Nephrectomy for Kidney Cancer Volume 183Issue 2February 2010Page: 752-758 Advertisement Copyright & Permissions© 2010 by American Urological AssociationKeywordstemperaturekidney neoplasmsinstrumentationcryosurgerykidneyMetricsAuthor Information Jennifer L. Young More articles by this author Surendra B. Kolla More articles by this author Donald L. Pick More articles by this author Petros Sountoulides More articles by this author Oskar G. Kaufmann More articles by this author Cervando G. Ortiz-Vanderdys More articles by this author Victor B. Huynh More articles by this author Adam G. Kaplan More articles by this author Lorena A. Andrade More articles by this author Kathryn E. Osann More articles by this author Michael K. Louie More articles by this author Elspeth M. McDougall More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...