Tolouee S A, Madsen M, Berg K D, Dahl C, Fode M, Azawi N H
a Department of Urology , Zealand University Hospital , Roskilde , Denmark.
b Institute of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark.
Scand J Urol. 2018 Oct-Dec;52(5-6):407-410. doi: 10.1080/21681805.2018.1524397. Epub 2018 Nov 18.
Due to the high incidence of benign lesions in renal masses, numerous studies have been performed to clarify the value of core needle biopsies. The aim of the present study was to describe the complication rate after renal tumor biopsies (RTB), in order to make recommendations on observation after the procedure.
Data from all patients who underwent percutaneous ultrasound-guided RTB between February 2013 and October 2016 due to CT verified solid renal masses were prospectively collected and kept in a well-maintained database. Complications were collected retrospectively and classified according to the Clavien-Dindo (CD) classification system.
Data from 224 consecutive patients were retrieved. Thirteen patients underwent unilateral repeat biopsies and three patients underwent bilateral biopsies; thus, a total of 240 procedures were analyzed. A total of 124 patients (51.7%) were discharged within 4 hours after the RTB procedures and 110 patients (45.8%) were discharged within 24 hours. The remaining six patients (2.5%) were hospitalized for more than 1 day, all due to co-morbidities which were unrelated to the procedure. In total, five patients (2.1%) experienced post-biopsy complications: one case of iatrogenic pneumothorax, one case of spontaneously resolving hematuria and three cases of fever. All complications were CD ≤2 and all patients with complications were discharged within 24 hours, except for one patient who was hospitalized for 3 days due to management of bone pain. No correlation was found between the number of biopsies and complication rate.
The overall complication rate following ultrasound-guided biopsies of renal tumors was low and all complications were mild. Given the current evidence, it is believed that ultrasound-guided RTB can be done as an outpatient procedure without the need for hospitalization.
由于肾肿块中良性病变的高发病率,已经进行了大量研究以阐明粗针活检的价值。本研究的目的是描述肾肿瘤活检(RTB)后的并发症发生率,以便对术后观察提出建议。
前瞻性收集2013年2月至2016年10月期间因CT证实的实性肾肿块而接受经皮超声引导下RTB的所有患者的数据,并保存在维护良好的数据库中。回顾性收集并发症并根据Clavien-Dindo(CD)分类系统进行分类。
检索了224例连续患者的数据。13例患者接受了单侧重复活检,3例患者接受了双侧活检;因此,共分析了240例手术。共有124例患者(51.7%)在RTB手术后4小时内出院,110例患者(45.8%)在24小时内出院。其余6例患者(2.5%)住院超过1天,均因与手术无关的合并症。总共有5例患者(2.1%)发生活检后并发症:1例医源性气胸,1例自发性血尿,3例发热。所有并发症的CD分级均≤2,除1例因骨痛处理住院3天外,所有并发症患者均在24小时内出院。未发现活检次数与并发症发生率之间存在相关性。
超声引导下肾肿瘤活检后的总体并发症发生率较低,且所有并发症均较轻。根据目前的证据,认为超声引导下的RTB可以作为门诊手术进行,无需住院。