1.Which lung cancer patients can choose cryotherapy?
(1)The volume is less than 3cm, but the patient has high surgical risk (mainly heart or lung insufficiency) which is not suitable for surgical resection;
(2) The patient refuses surgery;
(3) residual, recurrent or metastatic lesions in the lung after standard treatment;
(4) Reduction therapy for advanced lung cancer;
(5) Central type lung cancer who have lost the chance of surgery.
2.How to do cryotherapy for peripheral lung cancer?
It can be done under the guidance of CT, color ultrasound and thoracoscopy.
After anesthesia, the cryoprobe will be inserted into the lesion under the surveillance of color ultrasound and CT to start cryotherapy, and the ultrasound and CT examination will monitor the treatment effect during the treatment. The patient can eat and drink normally after lying down for 2-4 hours. During the whole procedure, the patient remains awake.
3.Is cryotherapy for lung cancer safe?
Cryotherapy for lung cancer requires lower physical condition of patients, which greatly reduces the risk of surgery and complication rate; it can monitor the treatment process and treatment effect without the limitation of anesthesia; elderly patients with pulmonary heart disease, hypertension and diabetes can tolerate this treatment, and the biggest advantages are: minimally invasive, bloodless, painless, and no obvious feeling during the whole treatment process. The most common complications include: (1) pneumothorax, which is caused by the gas entering the pleural cavity due to the penetration of the cryoprobe through the pleura. Generally a small amount of pneumothorax does not require treatment. (2) A small amount of postoperative coughing blood, which usually returns to normal after 3 days. (3) Mild postoperative fever with body temperature around 38 degrees, mainly due to absorption of frozen necrotic tumor tissue.
4.Can cryotherapy achieve curative effect for lung cancer?
For small tumors, cryotherapy can also achieve the effect of surgical cure. For larger tumors, it can be given in steps. In the treatment of lung cancer, radical freezing is a clinical cure if the effective freezing range is more than 1 cm above the tumor edge and the ice ball wraps around all the tumor tissues, and its efficacy is close to that of surgical resection, while palliative freezing is a cure if the freezing range is less than 80% of the tumor volume. Postoperative treatment combined with chemotherapy, radioactive particle implantation and traditional Chinese medicine can effectively control the tumor.
5.What is the principle of cryotherapy for lung cancer?
The principle of cryotherapy is that ice crystals are formed rapidly inside and outside the cells after cooling down, resulting in dehydration and rupture of tumor cells. At the same time, freezing causes microvascular constriction, blood flow slows down and micro thrombus formation, blocking blood flow, resulting in ischemic necrosis of tumor tissues. After repeated freezing and thawing of tumor cells, cell rupture and cell membrane dissolution prompt the release of intracellular and antigens in a masked state, stimulate the body to produce antibodies and improve the immune ability.
6.How to perform cryotherapy for central lung cancer?
Central type lung cancer is located in the large tracheobronchus, which forms airway blockage earlier, leading to lung atelectasis and earlier damage to lung function, and often the timing of surgery is missed or risky total pneumonectomy, bronchial sleeve resection and angioplasty have to be performed, with poor prognosis of surgery and poor quality of life. We apply the cryotherapy technique and perform cryotherapy under bronchoscopic guidance, which can make the tumor in the trachea disappear, airway recanalization, significantly improve ventilation, and improve the quality of life. Combined with chemotherapy and herbal medicine after surgery, most patients can prolong their survival. The operation is safe and simple, and patients can recover physically faster without complications such as hemoptysis.
7.How to do cryotherapy for central type lung cancer?
The bronchoscope enters through the nasal or oral cavity, while the probe is attached to the bronchoscope to enter. The end of the cryoprobe can act directly on the tumor area. Once in the tracheal lumen, the cryoprobe is started by depressing the foot pedal with the probe 4mm from the end of the bronchoscope and an ice ball appears at the end of the probe within 15mm. One to three freeze-thaw cycles lasting one minute are applied to the same or current area, with the end of the probe acting vertically in a tangential direction directly on and deep inside the mass.
The tissue is frozen to -60°C to -70°C. Any killed or necrotic tissue is removed with a biopsy forceps during or before the end of the cryotherapy procedure. Bronchoscopy is repeated once or twice a week, and cryotherapy can be performed again if needed, or the necrotic tissue can be removed directly.
8.What equipment is needed for cryosurgery?
Siemens 64-row spiral CT, which can image the tumor in three dimensions and make the cryosurgery operation very accurate; color ultrasound equipped with puncture locator, so that the operation can be monitored throughout the process; Stryker thoracoscope, so that the cryosurgery operation can be performed under direct vision, making the operation safer; fiberoptic bronchoscope for anesthesia, which can guide the cryoprobe for treatment under general anesthesia; Kulan surgical freezer, which is the core of the technology The equipment, which can inject refrigerant into the cryoprobe, reaches -150℃.
The bronchoscope enters through the nasal or oral cavity, and the probe is attached to the bronchoscope for entry. The end of the cryoprobe can act directly on the tumor area. Once in the tracheal lumen, the cryoprobe is started by depressing the foot pedal with the probe 4 mm from the end of the bronchoscope and an ice ball appears at the end of the probe within 15 mm. One to three freeze-thaw cycles lasting one minute are applied to the same or current area, with the end of the probe acting vertically in a tangential direction directly on and deep inside the mass.
The tissue is frozen to -60°C to -70°C. Any killed or necrotic tissue is removed with a biopsy forceps during or before the end of the cryotherapy procedure. Bronchoscopy is repeated once or twice a week, and cryotherapy can be performed again if needed, or the necrotic tissue can be removed directly.
8.What equipment is needed for cryosurgery?
Siemens 64-row spiral CT, which can image the tumor in three dimensions and make the cryosurgery operation very accurate; color ultrasound equipped with puncture locator, so that the operation can be monitored throughout the process; Stryker thoracoscope, so that the cryosurgery operation can be performed under direct vision, making the operation safer; fiberoptic bronchoscope for anesthesia, which can guide the cryoprobe for treatment under general anesthesia; Kulan surgical freezer, which is the core of the technology The equipment, which can inject refrigerant into the cryoprobe, reaches -150℃.