Cryosurgery is a minimally invasive and effective technique in locally advanced tumors

Open the abdomen and accessed through open prostate surgery is the usual surgical method to remove the malignant tumor of the male sex gland, which represents the most common urological cancer in men and the second leading cause of death from cancer disease after neoplasia lung.Asi It comes to a radical prostatectomy, which involves the removal of the entire gland. But nevertheless. when the tumor is locally advanced cancer cells spread outside the prostate is much more suitable minimally invasive cryosurgical treatment and a lower rate of side effects (urinary incontinence and impotence).

Cryosurgery for locally advanced prostate cancer is a relatively new method, which is being developed since the nineties in few hospitalles the world. It is a little bloody technique that reduces to one day a week in hospital that requires conventional operation. However, it requires a high initial investment in technical equipment and quali fi cation of the medical staff. For now, few Spanish hospitals that offer this operation. The Italian urologist Lugnani Franco, vice president of the International Society of Cryosurgery 

Surgery removes the gland, but in 30% of cases remaining residual tumor

this' traveling in recent weeks with some regularity to Madrid to teach Spanish teams crioquirurgic surgeons system. Lugnani part of the expert committee of the newly created Insti- tute of Advanced Urological Surgery (ICUA), an open medical facility, located in Madrid, which aims to provide, through educational actions and clinics the most modern diagnostic and therapeutic techniques in specialty the hand of domestic and foreign most experienced experts. The ICUA presented in February at the Royal Academy of Medicine, plans entreprender discussions with the National Health System to extend its services to the Spanish public health. "While conventional open surgery," explains the Italian urologist, "removes all gland, but there is a 30% risk of residual tumor and radiotherapy kills certain cancer cells but not other radioresistant Cryosurgery destroys both all malignant cells by freezing as both prostate tissue surrounding the prostate. The Cryosurgery is a reliable choice and effective when proper activation indicated, that is revolutionizing the management of prostate malignancy. "

According to Franco Lugnani there are many reservations among men for prostate checkups performed. "However," he adds, "as women usually respect their gynecological examinations, men should go to urólugo or andrologist to undergo a scan annually once they reached age 50. If there is a family history in parents and siblings and triples the risk in these cases should initiate revisions to annual property after 40 years. Similarly, the earlier the age of onset in this family tumor, the greater the risk. "It has been found that between 10% and 15% of cancers caused by genetic inheritance. When the tumor appears in less man 60 or when more than five members affected in the same family, it is suspected that its origin is heraditario and are nvolucrados the HPC-1 gene and others. The prostate problems are so common in the adult male representing half of the consultations of the male population in primary care. Of that percentage, 75% suffers a benign, approximately 15% suffer from cancer and other consulting for prostatis.

The main advantages this specialist appointment less aggressive ("the patient overnight only one day in the hospital") and are also smaller complications such as incontinence ("a frequent risk in open surgery") and impotence ("is is caring yestudiando much criopreservactión nerves involved in sexual power "). The Spanish urologist Fernando Gomez Sancha and Juan Ruiz de Burgos Moreno, codirectorcs the ICUA and disciples of Lugnani, a fi rm that cryosurgery is based on high technology and procedures just bloody; "Clinical experience and literature scientific are showing that 96% of patients undergoing this operation would return to choose it." According to Gomez Sancha, by this process leads to the prostate via percutaneous transperineal. "very briefly" account, "the technique involves the introduction into the region below the scrotal sac containing the testicles of a fi needles nas with temperature sensors and other special needles, the cryoprobes, by circulating high pressure gases argórn to cool and helium to heat. Thanks to the physical principles of Joule and Thompson, the cryoprobes they form a ball of snow, which is expanding at least 185 degrees Celsius. The whole process will be displayed using ultrasound guidance transrectal ". A judicio Ruiz de Burgos, it is a technology of vanguard that, as with so many medical techniques, the principle is expensive for the large investment required by gadgetry and technical means, since the applied material is for single use and the training required by the medical staff. "However," he explains, "the accumulated experience is showing that after five years of practicing cryosurgery on a minimum of 60 patients an effective saving is achieved

The cryoprobes form a snowball that unless espande 185 degrees

700,000 euros, as the hospital stay and all expenses under this heading are reduced significantly. An indisputable fact is also that psychological or emotional impact on the patient is much traumatic phenomenon with this system than with open surgery. "