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2015 ; 4
(1
): 491
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Post renal biopsy complication rate and diagnostic yield comparing hands free
(ultrasound-assisted) and ultrasound-guided biopsy techniques of renal allografts
and native kidneys
#MMPMID26380167
Ali H
; Murtaza A
; Anderton J
; Ahmed A
Springerplus
2015[]; 4
(1
): 491
PMID26380167
show ga
BACKGROUND: Real time ultrasound guided percutaneous kidney biopsy has become the
standard procedure to assess the pathology of native kidneys and renal
transplants. No specific technique has shown to be totally free of post biopsy
bleeding complications. Few Studies have looked at the rates of post biopsy
bleeding complications comparing different needle size, post biopsy haematoma
size, or clinical predictors of the complication rates. In this study we aim to
assess safety and adequacy of the real time ultrasound guided biopsy using free
hands (ultrasound-assisted) and ultrasound-guided technique. METHOD: The results
of 527 elective native and kidney transplant biopsy performed as a day case
procedure at Lancashire Teaching Hospitals were retrospectively reviewed (499
native and 28 allograft biopsies). Biopsies were grouped into 4 groups according
to the technique and the needle size; group 1 (n = 119; performed by free
hands-ultrasound assisted- technique using 14G needle) Group 2 (n = 59; performed
by free hands-ultrasound-assisted technique using 16G needle), group 3 (n = 195;
performed by ultrasound-guided technique using 14G), and group 4 (n = 154;
performed by ultrasound-guided technique using 16G). The 4 groups were matched in
age, sex, weight, haemoglobin, serum creatinine, INR, PT, and PTT time. RESULTS:
The overall tissue specimen was adequate in 80.45 % of the cases, with no
difference between group 1 and 3 (81.5 and 80.52 % respectively, p = 0.82) or
between group 2 and 4 (86.44 and 77.3 % respectively, p = 0.13). The overall
major complications rate was 2.84 %, with no difference between group 1 and 3
(2.5 and 1 % respectively, p = 0.30) or group 2 and 4 (5 and 4.5 % respectively,
p = 0.86). The overall minor complications was 3.7 % with no difference between
group 2 and 4 (3.3 and 5.84 % respectively, p = 0.46), however, minor
complications were higher in group 1 compared to group 3 (5.8 and 1 %
respectively, p = 0.01).There was no difference between using 14G and 16G needle
size in terms of tissue adequacy(p = 0.7), major complications (p = 0.2 for drop
in Hb >10 g/l, p = 0.08 for blood transfusion, p = 0.35 for embolization) or
minor complication items(p = 0.4 for drop in Hb, 10 g/l,p = 0.1 for haematuria,
p = 0.7 for hematoma). CONCLUSION: When using a 14G needle, there is higher risk
of minor complications in the free hands-(ultrasound-assisted) technique compared
to the ultrasound-guided technique. There is no difference in the rates of major
or minor complications between free hand and needle-guided technique using 16G
needles. Both techniques showed adequate tissue sampling.