By Atika Walujani Moedjiono
The good news for the elderly and those whose condition is weak so it may not be dissected. Now there is a surgical technique that only needs a hole for the needle size 2-8 mm, ie, cryosurgery alias Krio operation.
Cryosurgery is a new technique for cancer therapy Supervisory Board approved the U.S. Food and Drug Administration (FDA) in 1998 and China SFDA in 1999.
One of the executors of therapy, Fuda Cancer Hospital Guangzhou, China, using this technique since 2000. There are at least 5,000 cases of 34 types of cancer that have been handled Fuda Hospital. The experts at the hospital were also frequent train physicians from around the world about this technique.
So far, such as the International Society of Cryosurgery mentioned Chairman (International Society of Cryosurgery) Dr Franco Lugnani, Fuda Hospital has the most experience doing this minimally invasive surgery, as well as superior in terms of research and experience.
According to Prof. Xu Kecheng in the book Modern Cryosurgery for Cancer, Krio lethal tumor surgery through repeated freezing and thawing process. Damaging effects of Krio operation occurs through two mechanisms, direct and slower.
Direct effect is the formation of ice crystals that cause cancer cells become dehydrated and broken. Effects of a slower, freezing causes the small blood vessels that tumors defective tumor and died of oxygen deprivation.
“This action also triggers the body’s immune system. As a result, the remaining tumor cells are not damaged by the operation of Krio be eradicated by the immune system. This is called krioimunologi response, “said Xu who is also President of the RS Fuda. In addition, cancer cells become more sensitive to chemotherapy and radiotherapy that further therapy is more effective.
Depending on the size and location of tumor, Krio operations carried out through an operation without surgery, either by endoscopy or needle puncture technique directly to the tumor. Ablation is performed using argon-helium system with two to three times repeated, that is freezing with argon gas at temperatures up to -160 degrees Celsius, then the temperature is raised to be 20-40 degrees celsius with helium gas at the melting stage.
Freezing is done until the ice is formed surrounding the tumor. Normal tissue around the tumor 5-10 mm along the frozen part. In the large tumor, surgery is not performed as well, but the 2-3 stages of operation. This is possible because the procedure does not require open surgery. Needle inserted through the skin only.
According to Dr. Niu Lizhi, associate professor and Head of the Department of Surgery who had become Director of the Fuda Hospital, who met in his office late last February, Krio surgery takes approximately 1 hour.
According to Niu, Krio after surgery, the tumor is frozen too long will shrink and disappear, leaving only a scar. Clot will be absorbed by the body to melt or removed through the catheter. If the tumor tissue is turned off it is too large to be absorbed by the body is taken through surgery. Of course size is smaller and the surgery did not cause the spread of cancer cells.
Operating profit Krio, Niu said, is not painful and can kill the tumor without damaging the roots of healthy tissue. Krio is relatively small needle, the diameter of 24 mm. This technique may be a single therapy or in combination with chemotherapy and radiotherapy. There is evidence of cancer recurrence after surgery Krio is much smaller than regular surgery. In fact, Niu claims, the success of therapy is 90 percent.
Xu and Niu in the article in the book Modern Cryosurgery for Cancer, of 625 patients with advanced cancer of the lung in surgery Krio Fuda Hospital, 150 patients were followed for the development of 12-38 months. The result, the survival rate (survival rate) 1, 2, and 3 years respectively 64 percent, 45 percent and 32 percent.
Krio ideal technique is used for cancer of the liver, lung, eye retina (retinoblastoma), kidney, ovary (ovarian), pharynx (upper throat), testes (testicles), uterus, vagina, pancreas, breast, prostate, melanoma ( skin cancer), head and neck, sarcoma and bone cancer and soft tissue tumors.
That do not match, according to Niu, is a cancer of the stomach or intestines, because of the Krio surgery can actually cause stomach or intestinal leakage. “For cancer of the stomach, you should immediately dissected and the tumor was taken,” said Niu.
Developed for a long time
Freezing technique for the treatment of history stretching from ancient Egypt. Later, Hippocrates also aware of the effect of reduction of inflammatory pain and cold. In the mid-19th century, the technique developed by use of a mixture of salt and ice, continued use of air (oxygen and carbon monoxide) are compressed at the end of the 19th century to address various skin disorders, such as ulcers, warts, herpes, and so forth.
Beginning of the 20th century, the study continues with the utilization of carbon dioxide snow. Fine-needle technique and the discovery of nitrogen in the mid-20th century to allow operations such as oral cancer and cervical cancer, even freezing of brain tissue to cope with Parkinson’s disease.
Currently, the development of medical devices are capable of operating without a surgical guide, such as ultrasound, X-ray computed tomography, magnetic resonance imaging, manufacturing of various sizes as well needle Krio discovery of helium-argon system allows the use of very wide range of operating Krio.
Despite many benefits, it does not mean Krio operation without risk. Krio surgery can damage the liver bile ducts and blood vessels that can cause severe bleeding and infection. Krio in lung surgery can cause side effects such as pneumothorax and fluid in the pleura.
Krio in prostate surgery can interfere with the urethra, causing urinary incontinence (unable to control the discharge of urine) and impotence. Krio surgery on the bone can damage nearby tissues and bone fracture.
In certain circumstances may occur thrombocytopenia (decreased number of blood platelets), and even multiorgan failure (cryoshock) in an operation that can be fatal.
However, in the hands of experts, such as Niu said, all possibilities are taken into account and reduced to a minimum. In a way, the lighter side effects than with open surgery.