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Related Experiment Videos

Lethal tissue temperature during cervical cryotherapy with a small flat cryoprobe

D G Ferris1

  • 1Department of Family Medicine, Medical College of Georgia, Augusta 30912-3500.

The Journal of Family Practice
|February 1, 1994
PubMed
Summary
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A small flat cryoprobe tip used in cervical cryotherapy may not effectively treat all severe cervical dysplasia (CIN III). Inadequate treatment may occur in an estimated 12.5% of cases, suggesting alternative methods are needed.

Area of Science:

  • Gynecologic Oncology
  • Cryosurgery
  • Cervical Pathology

Background:

  • Cervical cryotherapy using a small flat cryoprobe tip is a common treatment for cervical intraepithelial neoplasia III (CIN III).
  • Treatment failures occur in some female patients, particularly those with CIN III.
  • The thermodynamic effects of small flat cryoprobe tips in cervical tissue have not been previously characterized.

Purpose of the Study:

  • To evaluate the temperature generation and freezing capability of a small flat cryoprobe tip during thermocouple-monitored cervical cryosurgery.
  • To determine if the cryoprobe can achieve lethal temperatures in cervical tissue to eradicate CIN III.

Main Methods:

  • A thermocouple was inserted into the cervix 5 mm from the cryoprobe margin.
  • Nitrous oxide cryosurgery was employed, with temperatures monitored by a pyrometer.

Related Experiment Videos

  • Iceball lateral spread was measured using a cryosurgical iceball gauge.

    • Main Results:

    • A minimum temperature of -2°C was achieved at the end of the 6.5-minute freeze.
    • The maximum lateral spread of the freeze was 6.2 mm.
    • An estimated lethal zone of 4.2 mm was calculated, considering a 2 mm recovery zone.

    Conclusions:

    • The small flat cryoprobe tip is insufficient to eradicate all severe premalignant cervical disease, especially within deep glandular clefts.
    • In vivo data suggest that approximately 12.5% of CIN III cases may be inadequately treated.
    • Electrosurgical loop excision of the cervical transformation zone (ELECTZ) may be a more suitable treatment for CIN III.