采用末端切割技术的前列腺活检长芯针：与标准针相比真的有优势吗？

The long core needle with an end-cut technique for prostate biopsy: does it really have advantages when compared with standard needles?

作者信息

Ozden Eriz, Göğüş Cağatay, Tulunay Ozden, Baltaci Sümer

机构信息

Department of Urology, School of Medicine, Ankara University, Ankara, Turkey.

出版信息

Eur Urol. 2004 Mar;45(3):287-91. doi: 10.1016/j.eururo.2003.10.004.

DOI:10.1016/j.eururo.2003.10.004

PMID:15036672

Abstract

OBJECTIVE

To evaluate the failure rate, core length and fragmentation rate for each different stroke length of the end-cut (BioPince) needle in order to show the performance of the needle for different stroke lengths and compare these with the standard side-notch needle.

METHODS

TRUS guided biopsy of the prostate was performed on 86 consecutive men between June 2002 and May 2003. The patients were randomized into two groups with 43 men in each group. Patients in group A underwent 8 core biopsy with the end-cut needle in different stroke lengths; 13, 23 and 33mm respectively. Patients in group B underwent 8 core biopsy with the side-notch needle. The cores have been evaluated and compared for failure rates, core lengths, number of core lengths under 5mm and fragmentation rates.

RESULTS

When the end-cut needle was used, a significant number of failure rates was noted; with an overall failure rate of 16%. The failure rates were 26% for 13mm stroke length, 18% for 23mm stroke length and 10% for 33mm stroke length respectively. These failure rates showed statistically significant difference from standard needle for overall and for every separate stroke length ( p<0.001 for all). Standard needle and the cores taken with 33mm stroke length of the end-cut needle had similar low fragmentation rates while 13 and 23mm stroke lengths had higher rates. Of the overall cores taken by BioPince needle, 46/344 (13%) of the cores were shorter than 5mm and this was significantly higher than the standard needle with 3/344 cores less than 5mm ( p<0.001). The end-cut needle when used with the 33mm stroke length has improved the core length by 68% according to the standard side-notch needle.

CONCLUSIONS

Our results showed that the performance of the end-cut needle worsens with decreased stroke lengths. The end-cut needle showed high failure rates which necessitates new punctures for taking a core. Additionally, the fragmentation rates are not lower than the standard needle and it has higher rates of taking small core samples. The only significant advantage of this needle over the standard needle is taking longer cores when it has been used at 33mm stroke lengths.

摘要

目的

评估端切式（BioPince）穿刺针在不同穿刺长度下的失败率、芯长度及破碎率，以展示该穿刺针对不同穿刺长度的性能表现，并与标准侧切口穿刺针进行比较。

方法

2002年6月至2003年5月，对86例连续男性患者进行经直肠超声引导下前列腺穿刺活检。患者随机分为两组，每组43例。A组患者使用端切式穿刺针以不同穿刺长度（分别为13、23和33毫米）进行8针穿刺活检；B组患者使用侧切口穿刺针进行8针穿刺活检。对获取的组织芯进行评估并比较失败率、芯长度、5毫米以下芯长度数量及破碎率。

结果

使用端切式穿刺针时，观察到显著的失败率；总体失败率为16%。13毫米穿刺长度的失败率为26%，23毫米穿刺长度的失败率为18%，33毫米穿刺长度的失败率为10%。总体及各单独穿刺长度下，这些失败率与标准穿刺针相比均有统计学显著差异（所有p<0.001）。标准穿刺针及端切式穿刺针33毫米穿刺长度获取的组织芯破碎率较低，而13和23毫米穿刺长度的破碎率较高。BioPince穿刺针获取的所有组织芯中，46/344（13%）的组织芯长度小于5毫米，这显著高于标准穿刺针的3/344（小于5毫米的组织芯）（p<0.001）。与标准侧切口穿刺针相比，端切式穿刺针在33毫米穿刺长度下使用时，芯长度提高了68%。