Department of Urology, University of California , Irvine, Orange, California.
J Endourol. 2018 Sep 12;32(9):884-890. doi: 10.1089/end.2018.0175. Epub 2018 Aug 10.
We surveyed United States of America-based urologists to characterize practice patterns and indications to perform a renal mass biopsy for small renal masses.
Members of the American Urological Association who practice in the United States were invited to participate in a 11-question web-based survey that was distributed via SurveyMonkey from December 2016 to January 2017.
There were 1131 respondents. The respondents equally represented all regions of the United States; the majority were in private practice. Overall, 32% of American urologists would "never" perform a biopsy of a renal mass ≤4 cm. Those who saw fewer than five small renal masses per year were more likely to "never" perform a renal biopsy on either a renal mass ≤4 cm or a renal mass 2-3 cm compared with those who saw more than five small renal masses per year (p < 0.001). Urologists who practiced at an academic hospital were more likely to perform a renal biopsy on both a renal mass ≤4 cm and a renal mass 2-3 cm compared with private practice and government-based urologists (p < 0.001 and p = 0.008 respectively). The primary reason for not performing a biopsy, cited by 68% of responding urologists, was that the results of a biopsy "would not change their management of the renal mass." Respondents independently performed only 2% of biopsies; however, almost half stated that they would be interested in learning office-based ultrasound-guided biopsy of a small renal mass.
Among members of the American Urological Association, biopsy of a small renal mass remains an underutilized diagnostic procedure, especially in light of 6000 unnecessary surgeries annually; nonuniversity-based urologists and those who see <5 renal mass cases each year infrequently perform a biopsy. Currently, interventional radiologists perform almost all small renal mass biopsies.
我们调查了美国的泌尿科医生，以了解他们对小肾肿瘤进行肾肿瘤活检的实践模式和适应证。
邀请美国泌尿外科学会的成员在美国参加一项基于网络的 11 个问题的调查，该调查于 2016 年 12 月至 2017 年 1 月通过 SurveyMonkey 分发。
共有 1131 名受访者。受访者代表了美国所有地区；大多数人在私人诊所工作。总的来说，32%的美国泌尿科医生“永远不会”对直径≤4cm 的肾肿瘤进行活检。与每年看 5 个以上小肾肿瘤的医生相比，每年看 5 个以下小肾肿瘤的医生更有可能“永远不会”对直径≤4cm 的肾肿瘤或 2-3cm 的肾肿瘤进行肾活检（p<0.001）。与私人执业和政府机构的泌尿科医生相比，在学术医院执业的泌尿科医生更有可能对直径≤4cm 和 2-3cm 的肾肿瘤进行肾活检（分别为 p<0.001 和 p=0.008）。68%的回复泌尿科医生表示，不进行活检的主要原因是活检“不会改变他们对肾肿瘤的治疗”。回复者仅独立进行了 2%的活检；然而，近一半的人表示他们有兴趣学习在办公室进行小肾肿瘤的超声引导活检。
在美国泌尿外科学会成员中，小肾肿瘤的活检仍然是一种未充分利用的诊断程序，特别是考虑到每年有 6000 例不必要的手术；非大学附属的泌尿科医生和每年看<5 例肾肿瘤的医生很少进行活检。目前，介入放射科医生几乎进行了所有的小肾肿瘤活检。
