cryosurgery

The use of cryoablation for colorectal liver metastases (CLM) remains limited and controversial. This study aimed to investigate the antitumor immune response following cryoablation combined with granulocyte-macrophage colony-stimulating factor (GM-CSF) treatment in a CLM mouse model.

A CLM mouse model was established using BALB/c mice. The tumor-bearing mice were randomly divided into Control group, GM-CSF group, cryoablation group, and cryoablation + GM-CSF group. Tumor size, survival time, dendritic cells (DCs) count, serum cytokine levels (IL-4, IFN-γ), and the Th1/Th2 ratio (IFN-γ/IL-4) were compared among the four groups.

The combination of cryoablation and GM-CSF demonstrated synergistic effects, resulting in the smallest tumor lesion, longest mean survival time, and highest DC count on day 21 post-treatment compared to other groups. Both cryoablation alone and combined with GM-CSF significantly increased serum IFN-γ levels and suppressed IL-4 levels on day 21 compared to pre-treatment levels (P<0.05). Notably, the combination of cryoablation and GM-CSF significantly elevated the Th1/Th2 ratio (P<0.05).

Combining cryoablation with GM-CSF treatment holds promise for CLM management. It exhibits increased DC infiltration within the tumor microenvironment, enhanced immune responses, and prolonged survival in tumor-bearing mice.

This research aimed to study the healing process of cryosurgical wounds after topical application of low-level laser and to evaluate its effects for the prevention of healing complications.

A total of 50 healthy male Wistar rats with an average weight of 200-250 g were selected and randomly divided into two main groups. In control group (N=25), cryosurgery was done without using of low-level laser. In experimental group (N=25), cryosurgery was done and the low-level laser was used for 10 days post-surgery. Each main group was divided into five subgroups (n=5) according to histopathological evaluation date (3, 7, 14, 21 and 28 days post-surgical) and healing process was evaluated on the wound specimens harvested at above-mentioned days. The full- thickness wounds were harvested in 40 mm in length and 20 mm in width and the specimens were stained using hematoxylin-eosin and Masson’s Trichrome staining. The healing process was evaluated and compared in groups by observation of granulation tissue and collagen fibers amounts, epithelial gap size, the number of inflammatory cells, and the rate of angiogenesis. Data were collected and statistically analyzed and compared between the experimental and control groups on specific days using the Kruskal-Wallis and Dan post hoc statistical tests.

The obtained data were compared between the experimental and control groups on different days using the Kruskal-Wallis and Dan post hoc statistical tests. The statistical results revealed significant differences between groups (P<0.05) in all mentioned variables. It revealed that the healing process in the experimental group took place at least one week earlier than the control group.

The results of this animal study showed that the low-level laser therapy on an experimental cryosurgical wound not only accelerates the healing process but also can be effective in the prevention of healing complications. The authors suggest further research to extend the results to human applications.

The Study Aimed To Compare The Results of Cryosurgery With Trichloroacetic Acid Chemical (TCA) Cautery For The Treatment of Hypertrophied Nasal Turbinates.

This was a prospective study of 70 patients with nasal obstruction due to hypertrophied nasal turbinates who were randomly divided in 2 groups of 35 each. In group 1, patients underwent inferior nasal turbinate reduction by cryosurgery and in group 2 patients with cautery by 50 % TCA. The patients were evaluated using SNOT-20 score pre and postoperatively on 6th month.

Significant improvement in symptoms was seen in 28 patients (80 %) in group 1 and in 10 patients (28.57%) in group 2..Improvement in average SNOT Score after cauterization of hypertrophied nasal turbinates by cryosurgery was from 55(severe) to 16(mild) and by TCA was from 54(severe) to 32(mod) in 6 months and this was statistically significant (p <0.001). Complications like bleeding, scarring, infection and adhesion formation were more with TCA than that of cryosurgery group and among these complications scarring was statistically significant (P =0.003).

The use of cryosurgical treatment for hypertrophied nasal turbinates is a safe, curative method as compared to that of TCA cautery which is less curative and with more complications.

Gingival hyperpigmentation is excessive deposition of melanin pigments in the epithelium of gingiva which affects facial esthetics. Various surgical methods for gingival depigmentation have been used to treat the darkened color of pigmented gingiva. This study compared the use of 940 nm diode laser and liquid nitrogen cryosurgery in the treatment of gingival physiologic hyperpigmentation in terms of gingival depigmentation, postoperative pain, healing duration, pigmentation recurrence, and patients’ satisfaction. Fifteen systemically healthy patients (11 females and 4 males; 17-35 years of age) with bilateral gingival physiologic hyperpigmentation were enrolled in this split-mouth randomized study. Maxillary anterior labial gingiva of each patient was divided into left and right halves, and each half was randomly depigmented by either laser or cryosurgery. Patients were given questionnaires to evaluate the procedures and were followed up in 3, 7, 10, 17 and 21 days postoperatively for the assessment of gingival healing and 1, 3, 6 and 12 months after the treatments to detect any sign of pigmentation recurrence. The severity of post-op pain measured by visual analogue scale (VAS) was mild to average and showed no significant difference between the 2 modalities (P > 0.05). There was no considerable swelling or hemorrhage after the treatment procedures and the healing duration was significantly shorter in laser (P < 0.05). The degree of pigmentation in all gingival sites treated by laser reached and remained at zero until the last follow up (1 year) and reached zero in 9 out of 15 cryosurgery-treated sites. All patients were completely satisfied with the laser, and 9 out of 15 were completely satisfied with cryosurgery. No pigmentation recurrence was observed during any follow-up periods. Removal of gingival physiologic hyperpigmentation by laser therapy and cryotherapy was effective and safe. The efficiency of the laser was better than cryotherapy.

Patients often complain about the esthetic problems of gingival pigmentation. The aim of this study was to compare the effectiveness and recurrence of diode laser 810 nm and cryosurgery for gingival depigmentation.
A total of 12 patients with physiologic gingival pigmentation were selected. The inclusion criterion was the presence of gingival pigmentation of maxillary incisors and the exclusion criteria was the presence of systemic diseases or use of any drugs associated with gingival pigmentation. For further evaluation, photographs were taken before and after treatment within the same position and light. Color analysis was done using the Adobe Photoshop software. Patients were treated by diode laser 810 nm - 2 w and on the opposite side cryosurgery was performed. Treatment was done under topical anesthesia if required. The laser beam was activated using the brush technique and in contact mode. Application period differed according to the degree of melanin pigmentation and epithelial thickness of the treated area. Cryosurgery was performed by a cotton swab. The swab was gently touched and rolled on the area for 10 to 15 seconds until the disappearance of gingival pigmentation. All patients were examined 1, 3, and 6 months after treatment.
Data were analyzed using the SAS software version 19. The degree of pigmentation was considered as follows: score1: mild pigmentation, score 2: average pigmentation, and score 3: intense pigmentation. The treatment of gingival pigmentation with laser and cryosurgery showed marked improvement of gingival pigmentation in both methods as well as no significant difference between the 2 methods after 1, 3, and 6 months of treatment.
Both methods are appropriate for the treatment of gingival depigmentation and no significant recurrence was observed during the 6 months follow - up.

Oral leukoplakia (OL) is a common premalignant lesion. The possible benefits of specific interventions in preventing a malignant transformation of OL are not well understood. This review assesses different invasive treatment techniques for OL and evaluate the optimal treatment possibilities.
A Medline (PubMed) search was conducted and heterogeneity between the studies was found, e.g., with regard to the OL lesions, patient groups, follow-up time, and definition of recurrence.
The recurrence and malignant transformation rate after the different treatment methods were evaluated. The mean overall recurrence rate varied with the treatment method.
A surgical treatment appears to decrease the risk of transformation but does not fully eliminate it. Follow-up should be done regardless of the surgical treatment.

Cryosurgery is one of the simplest, most effective gingival depigmentation methods. Repigmentation may happen after a while in each method. The aim of this study is to compare the recurrence rate after treatment by liquid nitrogen swap and a cryoprob in 18 months. A total of 26 patients with physiologic gingival pigmentation were selected. The anterior sextant was divided into left and right segments; each segment was treated randomly by swap technique or cryoprob. Standard photos were evaluated with photoshop software (Red, Green, Blue, Cyan, Magenta, Yellow, Black [RGB, CMYK]) before and at 2 week, 1,, ,, 12, 15, 18 months after the treatment. The results were compared, by the independent t-test and repeated measure ANOVA thereafter least signifi cant difference post-hoc. The viewpoints of patients and physicians regarding the treatment outcomes were obtained by a questionnaire and consequently evaluated qualitatively by McNemar test (P < 0.05 was considered as signifi cant level). The statistical analysis showed a signifi cant difference in color change after the treatment during 18 months, in each group (P < 0.001). The mean values of RGB had signifi cantly increased after 2 weeks in both methods (P < 0.001), but the differences from 2 weeks to 18 months after treatment were not signifi cant (P > 0.05). The mean values of CMYK signifi cantly decreased after 2 weeks in both methods (P < 0.001), but the differences from 2 weeks to 18 months after treatment were not signifi cant (P > 0.05). Qualitative evaluation showed the preference of the cryosurgery with swap method (P < 0.001). No signifi cant recurrence was observed during 18 months follow-up. Both methods of cryosurgery are appropriate in treatment of gingival depigmentation because no signifi cant recurrence was observed during 18 months follow-up.

Prostate cancer is one of the life threatening disorders of male. Although, over the last two decades, a high rate of overdiagnosis, and overtreatment has lowered the incidence rate of prostate cancer, the treatment or prevention strategies are not enough to control the high rate of disease related mortality. Current medical treatment approaches include surgery, radiation therapy, chemotherapy, hormonal therapy, cryosurgery and other methods. These approaches are more or less effective either as monotherapy or in multimodal approach. However, many adverse or side effects exist with these strategies. Researches are ongoing to find out the way or better strategies to eliminate the adverse effects. Dietary modifications may also contribute to decrease prostate cancer risk. Several nutraceuticals against prostate cancer have also been identified. This review article summarizes some of the current treatment, and prevention strategies with the protection of prostate cancer, which may be helpful to control and prevent this highly frequent life threatening disease.