Résumé
Objective:To investigate the feasibility, effectiveness and safety of ultrasound-guided transperineal prostate biopsy (TPB) with coaxial needle technique, and to improve the pain perception of TPB patients by reducing the number of direct perineal needling.Methods:A total of 200 patients who underwent ultrasound-guided TPB at the first clinical college of Three Gorges University & Yichang Central People′s Hospital from January 2019 to December 2020 were randomly divided into coaxial needle group (coaxial needle positioning puncture, n=100) and traditional group (traditional puncture frame guided repeated transperineal puncture, n=100). Visual analog scale (VAS) was used to evaluate the pain of patients during puncture. The number of samples, time-consuming of puncture, cancer detection rate, VAS pain score and complications between the two groups were compared. Results:The success rate of puncture in the coaxial needle group and the traditional group was 100%, and there was no significant difference in the cancer detection rate between the two groups (48% vs 40%, P>0.05). The average number of samples in the coaxial needle group was larger than that in the traditional group, the average puncture time in the coaxial needle group was less than that in the traditional group, and the average intraoperative VAS score of the coaxial needle group was lower than that of the traditional group, the differences were statistically significant[(14.8±1.8) vs (12.1±1.1), (12.9±1.3)min vs (16.5±1.9)min, (2.6±1.2) vs (4.4±1.4); all P<0.001]. The complication rate of the coaxial needle group was lower than that of the traditional group, the difference was statistically significant (18% vs 39%, P<0.001), the incidences of perineal hematoma and perineal pain in the coaxial needle group were lower than that in the traditional group (1% vs 8%, 8% vs 19%; all P<0.05). Conclusions:Coaxial needle technology for ultrasound-guided TPB can ensure the number of samples and accurate sampling in different areas, significantly reduce the number of direct perineal puncture, improve the pain in the process of puncture, reduce the incidence of postoperative perineal pain, with shorter operation time and fewer complications, which is worthy of clinical promotion.
Résumé
Objective To evaluate the effect of CT-guided percutaneous coaxial needle biopsy combined with microwave ablation (MWA) for the treatment of lung tumors, and to discuss its technique, safety, curative effect and clinical application value. Methods A total of 20 patients with lung tumor, who were admitted to the Department of Interventional Radiology, Shanghai Ruijin Hospital, China, during the period from August 2014 to June 2016, were collected. Among the 20 patients, primary pulmonary cancer was diagnosed in 9 and metastatic tumor in 11. A total of 23 tumor lesions were detected, and CT-guided percutaneous coaxial needle biopsy combined with MWA was performed for all lesions. Based on the size and shape of the tumor, the corresponding ablation power and time of duration were set up. After the treatment, the patients were followed up for 4-26 months, and chest enhanced CT examination was regularly reexamined to assess the curative effect. Results Percutaneous coaxial needle biopsy was carried out for 23 lesions, the tumor diameters ranged from 0.80 cm to 2.40 cm, with a mean of 1.39 cm. MWA was employed for 23 lesions. CT scan performed immediately after MWA showed that the density of tumor lesion became decreased, the diagnostic positive rate of needle biopsy was 83.3％. After the treatment, complete remission was obtained in 15 patients, partial remission in 2 patients, stable disease in one patient, and progression.