Hepatic cryosurgery in experiment and clinic

Abstract

The aim of the investigation – to study changes in hepatic tissue resulting from the influence of low temperatures (– 195,8 °C) in experiments and clinic. Hepatic tissue investigations in experiment have been carried out using electron and light microscopy. During the surgery instruments of original design have been used – cryoscalpels and cryodestructors. Experiments have been carried out on 45 sexually mature dogs of both sexes. Animals have been separated into 3 groups. On the first group (consisting of 12 animals), in the acute experiment, there have been studied features of cryoscalpel design characteristics. In the second series of experiment (on 22 dogs) there have been made a comparative study of hepatic resection using cryoultrasonic scalpel and simple surgical scalpel by means of the study of hemorrhage quantity. In 11 cases there have been studied hepatic morphological changes affected by cryoeffect. By the effect of low temperature ice crystals are appeared in hepatic tissue intracellularly and outside the cell, they cause mechanical injury and rupture of hepatic tissue. In 45 days connective tissue elements are formed at the place of cryodestruction. The use of cryoultrasonic scalpel in hepatic resection in the experiment decreases the hemorrhage quantity by 1,26 times as compared to the traditional methods. Positive experimental investigations allowed to use the low temperature with success in clinical practice at 253 patients with different localized hepatic diseases with 13 lethal outcomes (5,1%). Thus, the used cryosurgical technique during surgical operations allows to decrease significantly the hemorrhage, to eliminate parenchymatous bleeding and to prevent relapses of disease both at growths and at parasitic hepatic affection.