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Cryoablation in Hunan Cancer Hospital Precisely "Froze" the Kidney Tumor to Death
On August 2, under the guidance of Han Weiqing, the director of Urology Department of Hunan Cancer Hospital, Xieyu, the deputy director, has conducted a 3D printing technology assisted laparoscopic renal tumor cryosurgery successfully. After retrieval, it was the first time to adopt the combined use of 3D printing technology assisted laparoscopic renal tumor cryosurgery within our country.
Huang Liang (pseudonym) has undergone right kidney nephrectomy due to right kidney cancer 9 years ago. Recent examination has found that the cancer has transferred to the left kidney. Since the patient has only one kidney left, the cancer is very difficult to be treated. Has gone to many hospitals and clinics, griping the last hope, he came to Hunan Cancer Hospital for help.
After admitted to our hospital, the patient firstly has been provided with the traditional partial nephrectomy program by our urology experts. Altought it is apparently possible to survive replying on a life-long dialysis treatment after the surgery, the life quality would turn worse, and the expenses are also tremendous for this rural patient. The patient and his families have shown great pains after being informed of this treatment protocol.
Professor Xie Yu, then, has discussed again and again with his medical team, and finally decided to employ the “frozen” treatment, that is, Ar-He cryoablation. It is to use a freezing probe and insert it into the tumor center so that an ice ball will form around the center, thus to kill the tumor. The difficulties in cryotherapy are not only to avoid damage to normal tissues surrounding the tumor, but also to put the probe in the center of the tumor to achieve the best effects.
The patient’s renal tumor locates at the abdominal side, near the intestine. If the probe is directly punctured through skin, there would be a high risk of damage to the intestine. Therefore, in order to conserve the surrounding tissues, the medical team decides to use the laparoscopic assisted method, that is, to insert the freezing probe under the help of the laparoscope. However, the tumor is an endogenous one, with 70% located in the solid renal parenchyma. And most of it is invisible under direct vision. It is necessary to insert the probe through a perfect angle so that the probe is placed in the center to achieve the best freezing effect. In this case, the 3D printing technology is employed to print the equally-proportional physical models of the kidney and the tumor. The angle has been tested on these models pre-operatively in order to get the best puncturing angle.
After full preparation, experts from the Urology department and the Intervention Department have designed the best surgical protocol. On August 2, a hot summer day, the precisely tumor frozen surgery was carried out smoothly in the OR. At first, it separates the surrounding tissues from the kidney under the laparoscope to reveal the renal tumor. Then, it inserts the freezing probe into the renal tumor in accordance with the scheduled direction under the laparoscope successfully for the first time. The temperature falls to -140℃ rapidly. An “ice ball” forms around the tumor, lasting for 10 minutes. And the process is repeated for 3 times. This surgery afflicted the tumor with almost 170℃ temperature difference so that it killed the tumor to the largest extent. After the surgery, the patient only suffers 3 minimal cuts almost of button size.
The patient recovers well after surgery. Professor Xie Yu comments the combination of cryotechnique, laparoscopic technique and 3D printing technique as the unity of three swords to retain the renal function as well as to kill the tumor to the largest extent. It has become a new method to cure renal tumor within our country, and reached the goal of “individualized medicine” and “Precision Medicine”, benefiting more and more patients.