PubMed · 5931208
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J H Kaplan, H G Kudish. 1966. Endoscopic cryoprobe.. https://doi.org/10.1016/s0022-5347(17)63505-5
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It has been estimated that approximately 4 million Germans are suffering from actinic keratoses, which are considered as a carcinoma in situ today. Typically, actinic keratoses appear in sun-exposed skin areas, conventionally they have been treated by curettage and cryotherapy. In the last years, new therapeutic modalities with a high efficacy and patient contentment are available. Among these, the photodynamic therapy (PDT), the anti-tumor treatment with 3 % Diclofenac in 2.5 % hyaluronic acid as well as the introduction of Imiquimod as an immune response modifier are the most important. The rate of complete clearance from actinic keratoses varies between 50 and 90 % in clinical trials. In contrast to the conventional treatment modalities, these new options promise advantages in the treatment of field and offer excellent cosmetic outcomes, too. This overview will report on the actual treatment opportunities and a careful consideration in the year 2006.
The use of cold as a therapeutic agent has a long and colorful history. The Edwin Smith Papyrus, the most ancient medical text known, dated 3500 B.C., made numerous references to the use of cold as therapy. Baron de Larrey, a French army surgeon during Napoleon's Russian campaign, packed the limbs in ice prior to amputations to render the procedures painless. In the early twentieth century, a neurosurgeon, Temple Fay, pioneered "human refrigeration" as a treatment for malignancies and head injuries. In 1961, Irving Cooper developed the first closed cryoprobe system and ushered in the modern era of cryogenic surgery with his imperturbable convictions. Fay's early work fell victim to the disruptive sequel of the World War II. The Nazis confiscated his data (presented before the Third International Cancer Congress in 1939) forwarded to Belgium for publication and brutally applied his refrigeration techniques experimentally without any benefit of anesthesia in the concentration camps, especially Dachau. Hypothermia became associated in the public mind with the atrocities exposed at the war trials in Nürnberg. After lying dormant for decades, the interest was rekindled in the late 80s when mild hypothermia was shown to confer dramatic neuroprotection in a number of experimental models of brain injury. With several large multi-center clinical studies currently under way, hypothermia is receiving unprecedented attention from the medical and scientific communities.