[Cryosurgery of primary and metastatic cancers of the liver].
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.
Gignoux
B M
BM
Service 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
Ducerf
C
C
Mabrut
J Y
JY
Rivoire
M
M
Rode
A
A
Baulieux
J
J
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D003452:Cryosurgery / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors