Mecanismo de Lesión Tisular en Criocirugía

La criocirugia, modalidad efectiva de tratamiento medico, es una tecnica quirurgica que emplea la congelacion a temperaturas criogenicas para destruir tejidos biologicos no deseados. El objetivo de la criocirugia es congelar un determinado volumen tisular (para maximizar la destruccion celular) en una region predefinida y provocar necrosis sin dano significativo del tejido sano periferico. Las bases de la criocirugia son: "una rapida congelacion, una lenta y completa descongelacion, y repeticion de los ciclos de congelacion-descongelacion". Para explicar el dano en una criolesion se han propuesto muchos mecanismos de injuria inducidos por la congelacion. Los mecanismos son: (a) lesion celular directa, (b) lesion vascular, (c) apoptosis y (d) lesion inmunologica. La lesion que resulta de la criocirugia es compleja; por lo tanto, para controlar el resultado de este procedimiento es necesario comprender los mecanismos de dano en criocirugia. Cryosurgery, an effective medical treatment modality, is a surgical technique that employs freezing at cryogenic temperatures to destroy undesirable biological tissue. The goal of cryosurgery is to freeze a specified volume of tissue (to maximize cell destruction) within a predefined target region, resulting in necrosis without significant damage to the surrounding healthy tissues. Factors that facilitate this are: rapid freezing, slow and complete thawing, and repetition of the freeze-thaw cycle. To explain the injury within a cryolesion, many freezing induced injury mechanisms have been proposed. These mechanisms are 1) direct cell injury, 2) vascular injury, 3) cellular apoptosis, and 4) immunologic injury. The injury that results from cryosurgery is complex; therefore, to control the outcome of cryosurgery it is necessary to understand the mechanisms of damage in cryosurgery.