Renal subcapular saline injection during percutanoues renal cryoablation to prevent bowel injury.

INTRODUCTION: To evaluate the feasibility of percutaneous injection of saline in the renal subcapsular space to prevent bowel injury and histopathologic effects of bowel cryolesion during renal cryoablation in a porcine model. MATERIAL AND METHOD: Six pigs underwent percutaneous renal cryoablation with two freeze cycles in the lower pole of both kidneys. Six kidneys were injected with 10 ml saline into the renal subcapular space before cryoablation. The bowel was brought into contact with the edge of the ice ball with laparoscopic assistance during renal cryoablation, on the side with saline injection as well as on the control side. One of these animals was kept for survival follow-up and laparotomy for 7 days post cryoablation. The bowel cryolesion sites were observed and compared based on the presence or absence of renal subcapsular saline injection. RESULTS: The mean diameter of acute bowel injury with and without saline renal subcapsular injection was 7.25 +/- 1.26 and 14.5 +/- 0.58 mm, respectively. The influence of injecting a saline buffer was a significant decrease in the bowel cryolesion compared to controls (p = 0.0003). In addition, a pig kept for follow-up confirmed no bowel perforation after 7 days at a site that was cryolesioned on the side with renal subcapsular saline injection, but sustained bowel perforation in another segment lesioned by contact with a kidney without a saline injection. Gross and microscopic pathological examination was consistent with these interpretations. CONCLUSION: Preliminary results in a porcine model show that percutaneous renal subcapsular saline injection is a feasible and promising technique for preventing bowel complications of percutaneous image-guided renal cryoablation.

Chromosome analysis of uncultured amniocytes by comparative genomic hybridization in early amniocentesis.

OBJECTIVE: To study chromosome analysis by comparative genomic hybridization (CGH) compared with the conventional technique in early amniocentesis. MATERIAL AND METHOD: Cross-sectional descriptive study design was performed in 32 singleton pregnant women with gestational age between 12-15 weeks. Transabdominal amniocentesis was carried out under ultrasound guidance. The amniotic fluid samples were simultaneously investigated using CGH and the conventional cytogenetics study as a gold standard. RESULTS: Amniocentesis were done for advanced maternal age in all cases. The mean maternal age was 35.8 years (35-42 years). The mean gestational age was 13.7 weeks (12-15 weeks). The chromosome analysis by CGH technique of uncultured amniocyte showed 17 normal female chromosomes (53.1%) and 15 normal male chromosomes (46.9%). This finding was the same as the conventional cytogenetics method. The mean duration of the CGH method was 6 days and that of the conventional cytogenetics method was 13.7 days (10-23 days). CONCLUSION: The CGH technique is a reliable technique for a rapid prenatal diagnosis of chromosome study in early gestation.