LIQUID NITROGEN CANCER SURGERY

This is an amazing surgical procedure I wanted to share that I first heard presented at a conference 20 years ago by Dr. Tsuchiya from Kanazawa University in Japan. I thought it was an innovative approach to a very difficult problem of cancer of the bone.

In tumor surgery many times large sections of bone have to be removed - far bigger than the actual tumor itself to make sure that no tumor cells are left. In many cases this leads to a limb that's not usable at all. At that point the decisions are generally made to do an amputation and allow the patient to live with a prosthetic or to do multiple follow up surgical procedures to either bone graft the space or to use another technique to regrow bone. Sometimes the bone that was removed was such a large segment that bone graft is not practical because there simply is no place to get that amount of bone from the patient themselves. This new procedure removes the necessity of large bone resections.

The tumor is killed using liquid nitrogen and the dead tumor bone is left inside the body. At this point the bone is nothing more than a calcium scaffold and the patients healthy bone can now grow into it.

The way this surgery works is a portion of the tumor is removed completely but they do leave enough bone so that the overall architecture is still left. The bone is then cut a certain way all the soft tissue including muscles and flesh are removed from the bone and then the bone is dipped into liquid nitrogen for approximately 20 minutes. The extreme cold will kill all the cells in the bone that has been dipped. At that point the bone is removed from the liquid nitrogen and left to thaw at room temperature for approximately 15 minutes. Then the bone is placed into distilled water for another 10 minutes. At this time the bone can safely be placed back into the body and internal fixations such as screws pins and plates can reattach the bone to its original position at this time if there is the necessity of any bone graft it can be done. The picture below shows a tumor in the femur that is treated with this technique to eradicate the tumor cells.

This technique has shown remarkably good results over the years and has been written about quite often. I'm not so sure if any American surgeons are currently practicing this technique but if you are interested in learning more here is a link to the doctor who originally described it and also a link to one of the original articles on the subject.

Here is a link to a more recent article on liquid nitrogen bone tumor surgery. This is a recent review article that you may find interesting.