1.Comparison of Endoscopic Ultrasound Biopsy Needles for Endoscopic Ultrasound-Guided Liver Biopsy
Armen ESKANDARI ; Patrick KOO ; Heejung BANG ; Dorina GUI ; Shiro URAYAMA
Clinical Endoscopy 2019;52(4):347-352
BACKGROUND/AIMS: To compare the performance of latest commercially available endoscopic ultrasound biopsy needles. METHODS: Six latest commercially available needles were tested on a freshly harvested bovine liver; the tested needles included three 19 G, one 20 G, and two 22 G needles. Five biopsies were performed per needle with 10 mL of wet suction. The primary outcome was the number of complete portal tracts (CPTs) per needle aspirate. The secondary outcomes were the mean specimen length and mean fragment length. Analysis of variance and Tukey’s test were applied. RESULTS: All 19 G needles and the 20 G needle yielded similar mean CPTs and were superior to the SharkCore 22 G needle (p<0.001 adjusted for multiplicity). There was no statistically significant difference in total specimen length among the three 19 G needles and the 20 G needle tested. The two 22 G needles performed similarly with respect to the number of CPTs, mean fragment length, and mean specimen length (adjusted p=0.07, p=0.59, and p=0.10, respectively). CONCLUSIONS: The specimen adequacy was similar among the 3 latest commercially available 19 G needles. The endoscopist may choose a larger-bore needle based on availability without concerns of specimen adequacy. Further studies are needed to assess the ease of needle use in various anatomical locations and to confirm the optimal needle design.
Biopsy
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Biopsy, Fine-Needle
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Endosonography
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Liver
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Needles
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Suction
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Ultrasonography
2.Obesity Is Not Associated with Increased Operative Complications in Single-Site Robotic Partial Nephrectomy.
Christos KOMNINOS ; Patrick TULIAO ; Kyo Chul KOO ; Chien Hsiang CHANG ; Woong Kyu HAN ; Koon Ho RHA
Yonsei Medical Journal 2015;56(2):382-387
PURPOSE: To evaluate the impact of high body mass index (BMI) on outcomes following robotic laparoendoscopic single-site surgery (R-LESS) robotic-assisted laparoscopic partial nephrectomy (RPN). MATERIALS AND METHODS: Data from 83 Korean patients who had undergone robotic partial nephrectomy from 2006 to 2014 were retrospectively analyzed. The subjects were stratified into two groups according to WHO definitions for the Asian population, consisting of 56 normal range (BMI=18.5-24.99 kg/m2) and 27 obese (> or =25 kg/m2) patients. Outcome measurements included Trifecta achievement and the perioperative and postoperative comparison between high and normal BMI series. The measurements were estimated and analyzed with SPSS version 17. RESULTS: Tumor's complexity characteristics (R.E.N.A.L. score, tumor size) of both groups were similar. No significant differences existed between the two groups with regard to operative time (p=0.27), warm ischemia time (p=0.35) estimated blood loss (p=0.42), transfusion rate (p=0.48) renal function following up for 1 year, positive margins (p=0.24) and postoperative complication rate (p=0.34). Trifecta was achieved in 5 (18.5%) obese and 19 (33.9%) normal weight patients, respectively (p=0.14). In multivariable analysis, only tumor size was significantly correlated with the possibility of Trifecta accomplishment. CONCLUSION: Our findings suggest that R-LESS RPN can be effectively and safely performed in patients with increased BMI, since Trifecta rate, and perioperative and postoperative outcomes are not significantly different in comparison to normal weight subjects.
Adult
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Blood Transfusion
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Body Mass Index
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Female
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Humans
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Kidney Neoplasms/*surgery
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*Laparoscopy/adverse effects
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Male
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Middle Aged
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Nephrectomy/*methods
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Obesity/*complications
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Operative Time
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Outcome Assessment (Health Care)
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Postoperative Complications
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Republic of Korea
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Retrospective Studies
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Robotic Surgical Procedures/*methods
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*Robotics
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Treatment Outcome
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Warm Ischemia