ABSTRACT
Cryosurgery, or tissue destruction by controlled freezing, has been investigated as a possible alternative to surgical intervention in the treatment of many diseases. This technique, which falls under the larger category of thermal therapy, has its origins in the 1800s, when advanced carcinomas of the breast and uterine cervix were treated with iced saline solutions, first by Arnott (1851). Since those early times, this technique has been used routinely to treat malignancies on the surface of the body (i.e., dermatologic tumors) and has gained some acceptance as a clinical tool for the management of internal malignancies, such as prostate and liver carcinomas. The main advantages of the technique are the potential for less invasiveness and lower morbidity compared to surgical excision. However, two main barriers to the technique gaining widespread acceptance are lack of a suitable technique to visualize the cryosurgical iceball and lack of understanding regarding the destructive process of freezing within the body. The former has been reviewed recently (Rubinsky, 2000) and will not be discussed in this chapter. The study of the destructive process of freezing is the focus of this chapter and will be divided into two main areas: understanding the thermal history
that causes tissue destruction and understanding the mechanism by which freezing destroys tissue. The term “thermal history,” as used in this chapter, means the time-temperature history experienced by the tissue during a thermal insult.
