LAPAROSCOPIC MONITORING OF CRYOSURGICAL ABLATION OF THE PROSTATE

Cryosurgical ablation of the prostate has resurfaced as a potential tr eatment option for organ-confined adenocarcinoma of the prostate. This study examines the temperatures achieved at the anterior prostatic ca psule during the freeze-thaw cycle of transperineal cryosurgical ablat ion of the prostate. Additionally, as there was direct laparoscopic vi sualization of the prostate, frost forming outside the prostate would have been detected. Two patients underwent endoscopic extraperitoneal pelvic lymphadenectomy followed, with patients under the same anesthet ic, by transperineal cryosurgical ablation of the prostate. Nadir pros tatic capsular temperatures reached -28 and -36 degrees C, respectivel y, occurring approximately 13 min into the freezing phase. At these te mperatures, no frost was observed endoscopically at the ventral surfac e of the prostate. Ice was palpated with endoscopic probes several mil limeters below the ventral capsular surface. These nadir temperatures are lower than those of previous studies on cryosurgical ablation of t he human prostate. Further studies need to examine the temperatures re quired to produce cell death and to determine whether periprostatic ti ssues can be treated safely and effectively for locally advanced disea se.