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Published on: March 3, 2023
[Cryosurgery of primary and metastatic cancers of the liver]
B M Gignoux1, C Ducerf, J Y Mabrut
1Service de chirurgie digestive et de transplantation hépatique, hôpital de la Croix-Rousse, 103, Grande-Rue-de-la-Croix-Rousse, 69317 Lyon, France. benoit.gignoux@chu-lyon.fr
Abstract:
Cryosurgery is a method of in situ destruction of tissue by a freezing process. Results of hepatic cryosurgery are now available for more than 2100 patients and allow to assess its place in the treatment of hepatic malignancies. Mechanisms of tissue destruction and indications of cryosurgery are detailed. With a peri-operative mortality rate of 1.5%, the safety of hepatic cryosurgery is now admitted. Cryosurgery has its own morbidity: increase of transaminases levels, platelets drop, myoglobinuria and rarely renal failure or cryoshock. In selected patients, hepatic cryosurgery is feasible with a laparoscopic or percutaneous approach. Long term results do not support cryosurgery as an alternative to liver resection. This technique enlarges possibilities of surgical treatment for patients with primary and metastatic liver cancers.
Insights
Hepatic cryosurgery offers a safe treatment option for liver cancers, with a low mortality rate. While not a replacement for liver resection, it expands surgical possibilities for patients.
Area of Science:
- Oncology
- Surgical Innovation
Background:
- Cryosurgery utilizes freezing to destroy tissue in situ.
- Hepatic cryosurgery has been performed on over 2100 patients.
Purpose of the Study:
- To assess the role of hepatic cryosurgery in treating liver malignancies.
- To detail the mechanisms, indications, and outcomes of hepatic cryosurgery.
Main Methods:
- Review of results from over 2100 patients undergoing hepatic cryosurgery.
- Analysis of peri-operative safety, morbidity, and long-term outcomes.
- Evaluation of laparoscopic and percutaneous approaches.
Main Results:
- Hepatic cryosurgery demonstrates a peri-operative mortality rate of 1.5%.
- Common morbidities include elevated transaminases, thrombocytopenia, and myoglobinuria; rare complications include renal failure and cryoshock.
- Long-term results indicate it is not superior to liver resection.
Conclusions:
- Hepatic cryosurgery is a safe procedure for liver cancer treatment.
- This technique expands therapeutic options for primary and metastatic liver cancers, particularly in selected patients.
- It complements, rather than replaces, established treatments like liver resection.
