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In vitro studies show that new miniature cryoprobes are suitable for cryoablation …

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- Complications after cryosurgery with new miniature cryoprobes in long hollow bones: An animal trial

Mean duration of operation was 4 h 22 min, mean duration of anaesthesia 5 h 13 min. In 18 of 24 cases, the mean pulmonary-arterial pressure PAP and the mean central venous pressure (CVP) showed no significant changes at any of the 4 sampling times (Figs. 1 and 2). The PAP rose in 2 animals while in 4 other cases, the haemodynamics could not be determined for technical reasons. There was only a temporary increase of the mean PAP and CVP while the animals were in the right unilateral recumbent position, but all values normalised when the animals were shifted to their left side. The heart increased marginally during the operation (Fig. 3).

Blood gas analysis showed an increase in pCO2 at constant oxygen saturation after the animals were shifted to their right side. In 5 of the animals, the pCO2 remained slightly higher even after they were shifted to their left side. PH, base excess, electrolytes and lactate showed no changes at any sampling time. Hemoglobin decreased marginally (Fig. 4). The deep body temperature (taken central-venously) before and after cryosurgery was not obviously related to any single cryoablation, but it did show a mean decrease of 1.25°C over the course of the entire operation (Fig. 5). Clinical follow-up observations yielded no remarkable findings. The mean time of recovery – i.e., from the end of anaesthesia until the animals were able to stand up again – was 86 minutes. None of the 24 animals showed any clinically significant respiratory insufficiency. One animal developed a severe wound infection which required treatment. The wound was excised and showed secondary healing under antibiotics (Fig. 6).

Autopsy revealed clean scars in all animals. There were macroscopically and microscopically no signs of ongoing or resolved osteomyelitis. All vein samples were free of old or recent thrombi. The lungs were grossly unremarkable. Histology of the bronchopulmonary arteries showed no evidence of acute or cronic embolism or thrombus. Thus, none of the animals had suffered an embolism even at the segment level. Some did show a marked bronchial pneumonia, although it followed an asymptomatic course and was therefore of no consequence. No animal showed spontaneous fractures, and X-rays taken at the end of the trial revealed no evidence of healed fractures.

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