-
The Journal of Small Animal Practice Sep 2017The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2)...
OBJECTIVES
The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors.
METHODS
Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon.
RESULTS
Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors.
CLINICAL SIGNIFICANCE
Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence.
Topics: Abdomen; Animals; Biopsy; Cats; Digestive System Surgical Procedures; Dogs; Incidence; Retrospective Studies; Risk Factors; Surgical Wound Dehiscence
PubMed: 28762502
DOI: 10.1111/jsap.12696 -
Journal of the American Heart... Mar 2022Background Low-voltage areas (LVAs) in the atria of patients with atrial fibrillation are considered local fibrosis. We hypothesized that voltage reduction in the atria...
Background Low-voltage areas (LVAs) in the atria of patients with atrial fibrillation are considered local fibrosis. We hypothesized that voltage reduction in the atria is a diffuse process associated with fibrosis and that the presence of LVAs reflects a global voltage reduction. Methods and Results We examined 140 patients with atrial fibrillation and 13 patients with a left accessory pathway (controls). High-density bipolar voltage mapping was performed using a grid-mapping catheter during high right atrial pacing. Global left atrial (LA) voltage (V) in the whole LA and regional LA voltage (V) in 6 anatomic regions were evaluated with the mean of the highest voltage at a sampling density of 1 cm. Patients with atrial fibrillation were categorized into quartiles by V. LVAs were evaluated at voltage cutoffs of 0.1, 0.5, 1.0, and 1.5 mV. Twenty-eight patients with atrial fibrillation also underwent right atrial septum biopsy, and the fibrosis extent was quantified. Voltage at the biopsy site (V) was recorded. V results by category were Q1 (<4.2 mV), Q2 (4.2-5.6 mV), Q3 (5.7-7.0 mV), and Q4 (≥7.1 mV). V at any region was reduced as V decreased. V and V did not differ between Q4 and controls. The presence of LVAs increased as V decreased at any voltage cutoff. Biopsies revealed 11±6% fibrosis, which was inversely correlated with both V and V (=-0.71 and -0.72, respectively). V was correlated with V (=0.82). Conclusions Voltage reduction in the LA is a diffuse process associated with fibrosis. Presence of LVAs reflects diffuse voltage reduction of the LA.
Topics: Atrial Fibrillation; Atrial Function, Left; Atrial Remodeling; Biopsy; Catheter Ablation; Fibrosis; Heart Atria; Humans
PubMed: 35261287
DOI: 10.1161/JAHA.121.024521 -
Microsurgery Sep 2020The sural nerve is the most frequently harvested nerve autograft and is most often biopsied in the workup of peripheral neuropathy. While the complication types... (Review)
Review
BACKGROUND
The sural nerve is the most frequently harvested nerve autograft and is most often biopsied in the workup of peripheral neuropathy. While the complication types associated with these two procedures are well known, their clinical significance is poorly understood and there is a paucity of data regarding the complication rates.
METHODS
Pubmed search identified studies regarding complications after sural nerve harvest and biopsy. The data was grouped into sensory deficits, chronic pain, sensory symptoms, wound infections, wound complications, other postoperative complications, and complications impacting daily life. The incidence of each complication was calculated, and a chi-square analysis was performed to determine if there were any differences between nerve biopsies and graft harvest with respect to each complication.
RESULTS
Twelve studies yielded 478 sural nerve procedures. Sensory deficits occurred at a rate of 92.9%, chronic pain at 19.7%, sensory symptoms at 41.1%, wound infections at 5.7%, noninfectious wound complications at 7.8%, and impact on daily life at 5.0%. The differences in wound infections, sensory symptoms, and impact on daily life between biopsies versus graft excisions were found to reach statistical significance (p < .05).
CONCLUSIONS
Sural nerve excisions can cause chronic postoperative donor-site complications. Given these complications, alternative available mediums for nerve reconstruction should be explored and utilized wherever appropriate. If an alternative medium is unavailable and nerve autograft must be harvested for nerve reconstruction, then patients should be counseled about risks for developing donor site complications that may negatively affect quality of life.
Topics: Autografts; Biopsy; Humans; Morbidity; Postoperative Complications; Quality of Life; Sural Nerve
PubMed: 32277511
DOI: 10.1002/micr.30588 -
Retina (Philadelphia, Pa.) Nov 2022Controversy exists regarding the best method for biopsy of uveal melanoma. We describe our transvitreal technique and evaluate the safety of this technique as well as...
PURPOSE
Controversy exists regarding the best method for biopsy of uveal melanoma. We describe our transvitreal technique and evaluate the safety of this technique as well as the efficacy for obtaining sample for prognostic genetic profiling.
METHODS
Description of surgical technique and retrospective case series. Medical records for uveal melanoma patients who underwent transvitreal biopsy using our described technique were analyzed for tumor size, location, primary treatment, method of biopsy, and any complications thereof. Characteristics of tumors that underwent transvitreal biopsy were noted including tumor size, location, or presence of subretinal fluid, to see whether these affected surgeon preference for biopsy modality. A cohort of contemporaneous uveal melanoma patients who underwent biopsy through a transscleral technique served as a comparator group for these patient, tumor, and complication factors.
RESULTS
A total of 27 patients aged 27.2 to 88.6 years (mean 64.8) underwent transvitreal biopsy using our described technique between 2013 and 2016. There were 15 small, 10 medium, and 2 large tumors at diagnosis with the majority (n = 17) posterior to the equator. Intraoperative complications included a clot or small trickle of blood at the biopsy site in 20 (74.1%) of patients, small localized subretinal hemorrhage in 8 (29.6%), small vitreous hemorrhage in 4 (14.8%), and small transient choroidal detachments in 1 patient (3.6%). When subretinal hemorrhage occurred, it was almost always into a pre-existing pocket of subretinal fluid ( P = 0.0093). However, the presence of subretinal fluid was not associated with the decision to proceed with any biopsy ( P = 0.36) or transvitreal biopsy specifically ( P = 1.00). By 3 months, subretinal and/or vitreous hemorrhage resolved in essentially all cases. There were no cases of iatrogenic retinal detachment or extraocular tumor spread over a mean follow-up of 41.7 (range: 20-62.1) months. Adequate tissue for gene expression profiling was obtained from each biopsy. The comparator group of patients undergoing transscleral biopsy including 21 uveal melanomas in 20 patients (one eye had two melanomas). Transvitreal biopsies were more common in patients with small (n = 15; P < 0.0001), posterior (n = 17; P < 0.0001) tumors, compared with patients who underwent transscleral biopsy during the same period.
CONCLUSION
This technique can be used for small or posterior tumors or for small anterior tumors where a transscleral approach would risk tumor perforation. Complications were minor, transient, and self-limited. Biopsy yields for molecular prognosis were adequate in all cases. The presence of subretinal fluid may be considered a relative contraindication because it may lead to subretinal hemorrhage in the fluid pocket but did not dissuade us from using this transvitreal technique for patients who would benefit from it.
Topics: Humans; Vitreous Hemorrhage; Retrospective Studies; Biopsy, Fine-Needle; Uveal Neoplasms; Melanoma; Biopsy
PubMed: 31815876
DOI: 10.1097/IAE.0000000000002677 -
Gastrointestinal Endoscopy Aug 2017Endoscopic forceps biopsy and fixation are laborious and prolong the procedure and anesthesia. Multiple biopsy overcomes these shortcomings with a single endoscope pass...
BACKGROUND AND AIMS
Endoscopic forceps biopsy and fixation are laborious and prolong the procedure and anesthesia. Multiple biopsy overcomes these shortcomings with a single endoscope pass that cuts, like a needle biopsy, up to 25 biopsy samples of uniform size and depth during endoscope withdrawal. Biopsy specimens are collected in acquisition order and stored in a perforated plastic storage chamber within the perforated metal tip. The tip is cut off, immersed in fixative, and sent to pathology. A formatted log identifies each biopsy specimen by site and position. In pathology, the plastic storage cylinder, designed for processing and microtomy with biopsy specimens in situ, supports rapid diagnosis by frozen section and microwave or routine paraffin processing.
METHODS
After a 10-patient Institutional Review Board safety study and US Food and Drug Administration registration, biopsies were performed in 57 patients during colonoscopy, upper GI endoscopy, and ERCP. A blinded retrospective study compared colon surveillance biopsies in 15 patients who underwent multiple biopsy with 15 patients who underwent forceps biopsies performed by anonymous physicians on the same day. Patient information was removed from slides, and forceps biopsies were oriented manually for blinding.
RESULTS
Multiple biopsy specimens fixed and processed in situ were not significantly different from batched processed forceps biopsy specimens for depth, orientation, fixation, artifacts, and diagnostic information. Multiple biopsy colonic specimens were significantly (26%) smaller with better epithelial preservation than forceps specimens. Each biopsy saves 61 seconds during withdrawal.
CONCLUSIONS
Single-pass multiple biopsy reduces biopsy time with less specimen damage, work, workplace risk, and soiling. Diagnostic quality is equal to forceps biopsy with better epithelial preservation, although 26% smaller. In pathology, in situ processing and microtomy reduce work and workplace risk. Grossing and manual orientation are unnecessary. Rapid diagnosis by frozen section and microwave or paraffin processing are facilitated. Multiple biopsy speeds diagnosis and improves productivity in endoscopic biopsy and histopathologic processing.
Topics: Artifacts; Biopsy; Cholangiopancreatography, Endoscopic Retrograde; Colonoscopy; Equipment Design; Frozen Sections; Humans; Operative Time; Retrospective Studies; Single-Blind Method; Tissue Fixation
PubMed: 27988287
DOI: 10.1016/j.gie.2016.12.004 -
Journal of Clinical Pathology Sep 2001Bone marrow aspiration biopsies are carried out principally to permit cytological assessment but also for immunophenotypic, cytogenetic, molecular genetic, and other... (Review)
Review
Bone marrow aspiration biopsies are carried out principally to permit cytological assessment but also for immunophenotypic, cytogenetic, molecular genetic, and other specialised investigations. Often, a trephine biopsy is carried out as part of the same procedure. Bone marrow aspirations should be carried out by trained individuals who are aware of the indications, contraindications, and hazards of the procedure. They should follow a standard operating procedure. The operator should have made an adequate assessment of clinical and haematological features to ensure both that appropriate indications exist and that all relevant tests are performed. For the patient's comfort and safety, the posterior iliac crest is generally the preferred site of aspiration. Films of aspirated marrow and, when appropriate, films of crushed particles should be made and labelled. Once thoroughly dry, films should be fixed and stained. As a minimum, a Romanowsky stain and a Perls' stain are required. A cover slip should be applied. The bone marrow films should be assessed and reported in a systematic manner so that nothing of importance is overlooked, using a low power, then intermediate, then high power objective. A differential count should be performed. An interpretation of the findings, in the light of the clinical and haematological features, should be given. The report should be signed or computer authorised, using a secure password, and issued in a timely manner.
Topics: Biopsy, Needle; Bone Marrow; Bone Marrow Examination; Hematologic Diseases; Hematologic Neoplasms; Humans
PubMed: 11533068
DOI: 10.1136/jcp.54.9.657 -
The Journal of Urology Sep 2021The appropriate number of systematic biopsy cores to retrieve during magnetic resonance imaging (MRI)-targeted prostate biopsy is not well defined. We aimed to...
PURPOSE
The appropriate number of systematic biopsy cores to retrieve during magnetic resonance imaging (MRI)-targeted prostate biopsy is not well defined. We aimed to demonstrate a biopsy sampling approach that reduces required core count while maintaining diagnostic performance.
MATERIALS AND METHODS
We collected data from a cohort of 971 men who underwent MRI-ultrasound fusion targeted biopsy for suspected prostate cancer. A regional targeted biopsy (RTB) was evaluated retrospectively; only cores within 2 cm of the margin of a radiologist-defined region of interest were considered part of the RTB. We compared detection rates for clinically significant prostate cancer (csPCa) and cancer upgrading rate on final whole mount pathology after prostatectomy between RTB, combined, MRI-targeted, and systematic biopsy.
RESULTS
A total of 16,459 total cores from 971 men were included in the study data sets, of which 1,535 (9%) contained csPCa. The csPCa detection rates for systematic, MRI-targeted, combined, and RTB were 27.0% (262/971), 38.3% (372/971), 44.8% (435/971), and 44.0% (427/971), respectively. Combined biopsy detected significantly more csPCa than systematic and MRI-targeted biopsy (p <0.001 and p=0.004, respectively) but was similar to RTB (p=0.71), which used on average 3.8 (22%) fewer cores per patient. In 102 patients who underwent prostatectomy, there was no significant difference in upgrading rates between RTB and combined biopsy (p=0.84).
CONCLUSIONS
A RTB approach can maintain state-of-the-art detection rates while requiring fewer retrieved cores. This result informs decision making about biopsy site selection and total retrieved core count.
Topics: Aged; Biopsy, Large-Core Needle; Datasets as Topic; Feasibility Studies; Humans; Image-Guided Biopsy; Magnetic Resonance Imaging, Interventional; Male; Middle Aged; Multimodal Imaging; Multiparametric Magnetic Resonance Imaging; Neoplasm Grading; Prostate; Prostatectomy; Prostatic Neoplasms; Retrospective Studies; Spatial Analysis; Ultrasonography, Interventional
PubMed: 33908801
DOI: 10.1097/JU.0000000000001832 -
Computational and Mathematical Methods... 2022Axillary lymph node (ALN) staging is the most effective method to evaluate the condition of patients with breast cancer, their choice of treatment options, and...
BACKGROUND
Axillary lymph node (ALN) staging is the most effective method to evaluate the condition of patients with breast cancer, their choice of treatment options, and prognosis. The sentinel lymph node (SLN) status assessment is the key to sentinel lymph node biopsy (SLNB) in patients with breast cancer. The choice of tracer and tracer injection sites affects SLNB.
OBJECTIVE
This study mainly analyzes the best tracer for SLNB and the best choice of tracer injection site.
METHODS
A total of 165 breast cancer patients who underwent SLNB were selected and injected with methylene blue or 99mTc-labeled sodium phytate or nanocarbon 20 min before biopsy. The number of SLNs detected by different tracers in different injection sites such as peritumoral tissue (PT) and subareolar area (SA) was counted, and the sensitivity, specificity, and positive/negative prediction rates were recorded and compared.
RESULTS
The detection success rate, average detection number of SLNs, and detection accuracy of the nanocarbon tracer were higher than the other two. The detection sensitivity, specificity, and positive and negative prediction rates of nanocarbon for SLNB were also higher than those of the other two tracers. When comparing the performance of tracers in different injection sites, it was found that the detection of three tracers injected in the SA was better than the injection in the PT.
CONCLUSION
For women with early-stage breast cancer, nanocarbon can be used as the preferred tracer for SLNB to determine the status of the patient's ALNs, and the areola area can be used as the best injection site.
Topics: Axilla; Breast Neoplasms; Female; Humans; Lymph Nodes; Nipples; Sentinel Lymph Node Biopsy
PubMed: 35321201
DOI: 10.1155/2022/4066179 -
European Radiology May 2021This study evaluated the feasibility of DWI for lesion targeting in MRI-guided breast biopsies. Furthermore, it assessed device positioning on DWI during biopsy...
OBJECTIVES
This study evaluated the feasibility of DWI for lesion targeting in MRI-guided breast biopsies. Furthermore, it assessed device positioning on DWI during biopsy procedures.
METHODS
A total of 87 biopsy procedures (5/87 bilateral) consecutively performed between March 2019 and June 2020 were retrospectively reviewed: in these procedures, a preliminary DWI sequence (b = 1300 s/mm) was acquired to assess lesion detectability. We included 64/87 procedures on lesions detectable at DWI; DWI sequences were added to the standard protocol to localize lesion and biopsy device and to assess the site marker correct positioning.
RESULTS
Mass lesions ranged from 5 to 48 mm, with a mean size of 10.7 mm and a median size of 8 mm. Non-mass lesions ranged from 7 to 90 mm, with a mean size of 33.9 mm and a median size of 31 mm. Positioning of the coaxial system was confirmed on both T1-weighted and DWI sequences. At DWI, the biopsy needle was detectable in 62/64 (96.9%) cases; it was not visible in 2/64 (3.1%) cases. The site marker was always identified using T1-weighted imaging; a final DWI sequence was acquired in 44/64 cases (68.8%). In 42/44 cases (95.5%), the marker was recognizable at DWI.
CONCLUSIONS
DWI can be used as a cost-effective, highly reliable technique for targeting both mass and non-mass lesions, with a minimum size of 5 mm, detectable at pre-procedural DWI. DWI is also a feasible technique to localize the biopsy device and to confirm the deployment of the site marker.
KEY POINTS
• MRI-guided breast biopsy is performed in referral centers by an expert dedicated staff, based on prior MR imaging; contrast agent administration is usually needed for lesion targeting. • DWI represents a feasible, highly reliable technique for lesion targeting, avoiding contrast agent administration. • DWI allows a precise localization of both biopsy needle device and site marker.
Topics: Biopsy; Breast; Breast Neoplasms; Contrast Media; Diffusion Magnetic Resonance Imaging; Feasibility Studies; Humans; Magnetic Resonance Imaging; Retrospective Studies; Sensitivity and Specificity
PubMed: 33128183
DOI: 10.1007/s00330-020-07396-2 -
Kidney360 Sep 2021
Topics: Biopsy; Edema; Electronic Health Records; Humans; Renal Insufficiency, Chronic
PubMed: 35373111
DOI: 10.34067/KID.0004392021