Objective. - To demonstrate that cryotherapy is a powerful method to treat symptomatic benign ectopy of the uterine cervix. Patients and methods. - Sixty- five patients with benign ectopy of the uterine cervix were re...Objective. - To demonstrate that cryotherapy is a powerful method to treat symptomatic benign ectopy of the uterine cervix. Patients and methods. - Sixty- five patients with benign ectopy of the uterine cervix were recruited at the colposcopy clinic of Belfort’s hospital (France) between July 2002 and August 2003. Women with ectopy were treated for four main symptomatic reasons: abundant leucorrhoea, contact bleeding and recurrent cervicitis and also pelvic pain. Cryosurgery consisted in the use of nitrogen oxide at - 89° C to destroy the ectopic columnar epithelium by freezing, transmitted to the lesion through a flat cryode. Neither anaesthesia nor analgesia was required. A colposcopic examination was realised three to six months later (N=63). If there remained residual symptoms or ectopy, cryotherapy was used oncemore. Results. - Indications to treat were 92.3% for abundant leucorrhoea, 21.5% for contact bleeding, 6.2% for recurrent cervicitis, 4.6% for pelvic pain and 4.6% for abnormal cervical smears. Two cryosurgery procedures were necessary in only 27.7% of cases. A symptomatic cure rate of 95.2% was obtained and ectopy completely disappeared in 98.4% of cases. The ratio “ size of the residual ectopy/size of the initial lesion" varied from 12.5% to 50% . After treatment, no severe complication was observed except hydrorrhoea for a few days. Discussion and conclusion. - Cryotherapy remains one of the best methods to treat symptomatic ectopy of the uterine cervix. Moreover, it is a technique which is easy to acquire and practise and which is completely painless for women.展开更多
Endoscopic cryotherapy is a relatively new thermal ablative modality used for the treatment of neoplastic lesions of the esophagus. It relies on cycles of rapid cooling and thawing to induce tissue destruction with a ...Endoscopic cryotherapy is a relatively new thermal ablative modality used for the treatment of neoplastic lesions of the esophagus. It relies on cycles of rapid cooling and thawing to induce tissue destruction with a cryogen(liquid nitrogen or carbon dioxide) leading to intra and extra-cellular damage. Surgical treatment was once considered the standard therapeutic intervention for neoplastic diseases of the esophagus and is associated with considerable rates of morbidity and mortality. Several trials that evaluated cryotherapy in Barrett's esophagus(BE) associated neoplasia showed reasonable efficacy rates and safety profile. Cryotherapy has also found applications in the treatment of esophageal cancer, both for curative and palliative intent. Cryotherapy has also shown promising results as salvage therapy in cases refractory to radiofrequency ablation treatment. Cryoballoon focal ablation using liquid nitrogen is a novel mode of cryogen delivery which has been used for the treatment of BE with dysplasia and squamous cell carcinoma. Most common side effects of cryotherapy reported in the literature include mild chest discomfort, esophageal strictures and bleeding. In conclusion, cryotherapy is an effective and safe method for the treatment of esophageal neoplastic processes, ranging from early stages of low grade dysplasia to esophageal cancer.展开更多
文摘Objective. - To demonstrate that cryotherapy is a powerful method to treat symptomatic benign ectopy of the uterine cervix. Patients and methods. - Sixty- five patients with benign ectopy of the uterine cervix were recruited at the colposcopy clinic of Belfort’s hospital (France) between July 2002 and August 2003. Women with ectopy were treated for four main symptomatic reasons: abundant leucorrhoea, contact bleeding and recurrent cervicitis and also pelvic pain. Cryosurgery consisted in the use of nitrogen oxide at - 89° C to destroy the ectopic columnar epithelium by freezing, transmitted to the lesion through a flat cryode. Neither anaesthesia nor analgesia was required. A colposcopic examination was realised three to six months later (N=63). If there remained residual symptoms or ectopy, cryotherapy was used oncemore. Results. - Indications to treat were 92.3% for abundant leucorrhoea, 21.5% for contact bleeding, 6.2% for recurrent cervicitis, 4.6% for pelvic pain and 4.6% for abnormal cervical smears. Two cryosurgery procedures were necessary in only 27.7% of cases. A symptomatic cure rate of 95.2% was obtained and ectopy completely disappeared in 98.4% of cases. The ratio “ size of the residual ectopy/size of the initial lesion" varied from 12.5% to 50% . After treatment, no severe complication was observed except hydrorrhoea for a few days. Discussion and conclusion. - Cryotherapy remains one of the best methods to treat symptomatic ectopy of the uterine cervix. Moreover, it is a technique which is easy to acquire and practise and which is completely painless for women.
文摘Endoscopic cryotherapy is a relatively new thermal ablative modality used for the treatment of neoplastic lesions of the esophagus. It relies on cycles of rapid cooling and thawing to induce tissue destruction with a cryogen(liquid nitrogen or carbon dioxide) leading to intra and extra-cellular damage. Surgical treatment was once considered the standard therapeutic intervention for neoplastic diseases of the esophagus and is associated with considerable rates of morbidity and mortality. Several trials that evaluated cryotherapy in Barrett's esophagus(BE) associated neoplasia showed reasonable efficacy rates and safety profile. Cryotherapy has also found applications in the treatment of esophageal cancer, both for curative and palliative intent. Cryotherapy has also shown promising results as salvage therapy in cases refractory to radiofrequency ablation treatment. Cryoballoon focal ablation using liquid nitrogen is a novel mode of cryogen delivery which has been used for the treatment of BE with dysplasia and squamous cell carcinoma. Most common side effects of cryotherapy reported in the literature include mild chest discomfort, esophageal strictures and bleeding. In conclusion, cryotherapy is an effective and safe method for the treatment of esophageal neoplastic processes, ranging from early stages of low grade dysplasia to esophageal cancer.
