scholarly journals Open Versus Percutaneous Approach of Renal Tumor Biopsy at Cipto Mangunkusumo Hospital: A Single-center Experience

2021 ◽  
Vol 9 (B) ◽  
pp. 547-551
Author(s):  
Luki Ertandri ◽  
Agus Rizal A.H. Hamid ◽  
Meilania Saraswati ◽  
Chaidir A. Mochtar ◽  
Rainy Umbas
Keyword(s):  
Blood Loss ◽  
Renal Biopsy ◽  
Renal Tumor ◽  
Percutaneous Biopsy ◽  
Similar Efficacy ◽  
Percutaneous Technique ◽  
Open Approach ◽  
Tumor Biopsy ◽  
Therapy Regimen ◽  
Single Center Experience

BACKGROUND: Renal tumor biopsy is beneficial as it is capable of distinguishing between histological types of renal tumor; hence, it plays an important role in deciding the best therapy regimen. AIM: This study aims to evaluate the clinical experiences of renal biopsy in Cipto Mangunkusumo National Referral Hospital (RSCM), with both a percutaneous and open approach. It also aims to analyze the indications, results, intraoperative information, and complications of the two approaches. METHODS: This study was conducted using the retrospective cohort design; meanwhile, data were collected from RSCM from 1990 to 2019. The biopsy sample was taken using percutaneous and open renal biopsy, while comparative analysis was done between the two biopsy approaches. RESULTS: Data were collected from 33 patients that underwent renal biopsy from 1990 to 2019. Majority of the cases were diagnosed as unresectable renal tumor, while histological examination found clear cell carcinoma in most of the cases (73%). Furthermore, the open approach showed longer duration and higher blood loss compared to percutaneous technique with median 60 (30–120) versus 30 (5–60) min (p < 0.001) and 100 (5–650) versus 2 (1–5) ml (p < 0.001), respectively. In general, complications were reported to be low for both techniques. CONCLUSION: Based on the results, percutaneous renal biopsy has similar efficacy and complications rates in tumor sampling for histopathology together with open approach. However, there were significant differences in the duration and blood loss; hence, percutaneous biopsy is more favorable.

scholarly journals Juxtaglomerular cell tumor diagnosed preoperatively by renal tumor biopsy

2021 ◽  
Author(s):  
Takashi Ueda ◽  
Yukiko Morinaga ◽  
Kai Inoue ◽  
Sojiro Hirano ◽  
Hiroki Matsubara ◽  
...  
Keyword(s):  
Renal Tumor ◽  
Cell Tumor ◽  
Tumor Biopsy ◽  
Juxtaglomerular Cell ◽  
Juxtaglomerular Cell Tumor

scholarly journals Predictors of complications occurring after open and robot-assisted prostate cancer surgery: a retrospective evaluation of 1062 consecutive patients treated in a tertiary referral high volume center

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Marco Sebben ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Blood Loss ◽  
Open Approach ◽  
Intraoperative Blood Loss ◽  
Tertiary Referral ◽  
Robot Assisted ◽  
The Third ◽  
Major Complications

AbstractTo investigate factors associated with the risk of major complications after radical prostatectomy (RP) by the open (ORP) or robot-assisted (RARP) approach for prostate cancer (PCa) in a tertiary referral center. 1062 consecutive patients submitted to RP were prospectively collected. The following outcomes were addressed: (1) overall postoperative complications: subjects with Clavien-Dindo System (CD) one through five versus cases without any complication; (2) moderate to major postoperative complications: cases with CD < 2 vs.  ≥ 2, and 3) major post-operative complications: subjects with CDS CD ≥  3 vs.  < 3. The association of pre-operative and intra-operative factors with the risk of postoperative complications was assessed by the logistic regression model. Overall, complications occurred in 310 out of 1062 subjects (29.2%). Major complications occurred in 58 cases (5.5%). On multivariate analysis, major complications were predicted by PCa surgery and intraoperative estimated blood loss (EBL). ORP compared to RARP increased the risk of major CD complications from 2.8 to 19.3% (OR = 8283; p < 0.0001). Performing ePLND increased the risk of major complications from 2.4 to 7.4% (OR = 3090; p < 0.0001). Assessing intraoperative blood loss, the risk of major postoperative complications was increased by BL above the third quartile when compared to subjects with intraoperative blood loss up to the third quartile (10.2% vs. 4.6%; OR = 2239; 95%CI: 1233–4064). In the present cohort, radical prostatectomy showed major postoperative complications that were independently predicted by the open approach, extended lymph-node dissection, and excessive intraoperative blood loss.

scholarly journals Differences in soft tissue damage using a percutaneous versus open approach for antegrade straight humeral nailing: a quantitative and qualitative anatomical study

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110105
Author(s):  
Christian Fang ◽  
Dennis KH Yee ◽  
Tak Man Wong ◽  
Evan Fang ◽  
Terence Pun ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Humeral Head ◽  
External Rotation ◽  
Biceps Tendon ◽  
Anatomical Study ◽  
Percutaneous Technique ◽  
Open Approach ◽  
Entry Site ◽  
Intramedullary Canal ◽  
Percutaneous Insertion

Background: Percutaneous insertion of third-generation straight humeral nails is a recent alternative to the conventional open method. Rather than splitting, retracting and subsequently repairing the supraspinatus fibers to visualize the humeral head entry site, the percutaneous approach utilizes a cannulated awl to enter the intramedullary canal through the supraspinatus fibers without visualizing internal shoulder structures. Despite recent evidence demonstrating satisfactory outcomes in the percutaneous method, the potential for iatrogenic injury to the rotator cuff and other shoulder structures is not fully understood. Materials and Methods: We performed an anatomical study of 46 shoulders in 23 cadavers to compare damage caused to internal shoulder structures between the open and percutaneous techniques. Dimensions and morphologies of supraspinatus and humeral head perforations were recorded. Results: The percutaneous technique produced greater latitudinal tearing ( p = 0.002) and less longitudinal tearing ( p < 0.001) of muscle fibers, however there was no difference in supraspinatus hole area ( p = 0.748). The long head biceps tendon was within 3 mm of the bone entry hole in 13 (28%) shoulders, with one shoulder in the open group exhibiting full tendon transection. Conclusions: Percutaneous insertion of intramedullary nails using a cannulated awl appears to produce similar soft tissue and bone entry site morphology as compared to the conventional open technique. The percutaneous method was associated with slightly greater latitudinal tearing, however the effects of this remain to be clarified through clinical studies. External rotation should be avoided during instrumentation to reduce the risk of biceps tendon transection.

Needle Tract Seeding Following Renal Tumor Biopsy: Scarcely a Concern or a Concern to Scare?

2019 ◽  
Vol 75 (5) ◽  
pp. 868-870 ◽  
Author(s):  
Ardalan E. Ahmad ◽  
Alexander Kutikov ◽  
Antonio Finelli
Keyword(s):  
Renal Tumor ◽  
Tumor Biopsy ◽  
Needle Tract ◽  
Needle Tract Seeding

scholarly journals Renal Tumor Biopsy Technique

2016 ◽  
Vol 129 (10) ◽  
pp. 1236-1240
Author(s):  
Lei Zhang ◽  
Xue-Song Li ◽  
Li-Qun Zhou
Keyword(s):  
Renal Tumor ◽  
Tumor Biopsy ◽  
Biopsy Technique

Development of an in vivo experimental model for percutaneous vertebroplasty in sheep

2012 ◽  
Vol 25 (03) ◽  
pp. 173-177 ◽  
Author(s):  
L. M. Benneker ◽  
A. Gisep ◽  
J. Krebs ◽  
P. F. Heini ◽  
V. Boner ◽  
...  
Keyword(s):  
Animal Model ◽  
Percutaneous Vertebroplasty ◽  
Quantitative Computed Tomography ◽  
Lumbar Vertebrae ◽  
Percutaneous Technique ◽  
Open Approach ◽  
Needle Position ◽  
Valid Animal Model ◽  
Clinical Conditions

SummaryIntroduction: Several studies have described ‘open’ approach techniques for cementation of sheep and goat vertebrae; however, no percutaneous technique has been developed so far for use in non-primates. The aim of this study was to develop an animal model for percutaneous vertebroplasty under clinical conditions.Methods: In a pilot study with dissected cadaveric ovine vertebrae, the technique and instruments as well as the optimal needle position were determined. In an in vivo animal study using 33 lumbar vertebrae of 11 sheep, a percutaneous vertebroplasty was performed under general anaesthesia. Needle position and cement volume were evaluated from high resolution, quantitative computed tomography imaging.Results: The percutaneous technique for vertebroplasty was applicable to the vertebral bodies (L1 to L5) of the ovine lumbar spine without any related adverse effects for the animals. The procedure showed a steep learning curve represented by the reduction of the distance between the actual and planned needle positioning (7.2 mm to 3.7 mm; median value) and shorter surgery times (21.3 min to 15.0 min, average) with progression of the study.Conclusion: The described technique is feasible and repeatable under clinical conditions. This is the first percutaneous vertebroplasty technique for non-primates and we conclude that the sheep is a valid animal model to investigate the effects of cement augmentation in vivo.

scholarly journals Comparison of open and minimally invasive surgery for intradural-extramedullary spine tumors

2015 ◽  
Vol 39 (2) ◽  
pp. E11 ◽  
Author(s):  
Albert P. Wong ◽  
Rishi R. Lall ◽  
Nader S. Dahdaleh ◽  
Cort D. Lawton ◽  
Zachary A. Smith ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Operative Time ◽  
Open Group ◽  
Perioperative Outcomes ◽  
Open Approach ◽  
Open Resection ◽  
Spine Tumors ◽  
Intradural Extramedullary

OBJECT Patients with symptomatic intradural-extramedullary (ID-EM) tumors may be successfully treated with resection of the lesion and decompression of associated neural structures. Studies of patients undergoing open resection of these tumors have reported high rates of gross-total resection (GTR) with minimal long-term neurological deficit. Case reports and small case series have suggested that these patients may be successfully treated with minimally invasive surgery (MIS). These studies have been limited by small patient populations. Moreover, there are no studies directly comparing perioperative outcomes between patients treated with open resection and MIS. The objective of this study was to compare perioperative outcomes in patients with ID-EM tumors treated using open resection or MIS. METHODS A retrospective review was performed using data collected from 45 consecutive patients treated by open resection or MIS for ID-EM spine tumors. These patients were treated over a 9-year period between April 2003 and October 2012 at Northwestern University and the University of Chicago. Statistical analysis was performed to compare perioperative outcomes between the two groups. RESULTS Of the 45 patients in the study, 27 were treated with the MIS approach and 18 were treated with the open approach. Operative time was similar between the two groups: 256.3 minutes in the MIS group versus 241.1 minutes in the open group (p = 0.55). Estimated blood loss was significantly lower in the MIS group (133.7 ml) compared with the open group (558.8 ml) (p < 0.01). A GTR was achieved in 94.4% of the open cases and 92.6% of the MIS cases (p = 0.81). The mean hospital stay was significantly shorter in the MIS group (3.9 days) compared with the open group (6.1 days) (p < 0.01). There was no significant difference between the complication rates (p = 0.32) and reoperation rates (p = 0.33) between the two groups. Multivariate analysis demonstrated an increased rate of complications in cervical spine tumors (OR 15, p = 0.05). CONCLUSIONS Thoracolumbar ID-EM tumors may be safely and effectively treated with either the open approach or an MIS approach, with an equivalent rate of GTR, perioperative complication rate, and operative time. Patients treated with an MIS approach may benefit from a decrease in operative blood loss and shorter hospital stays.

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