The Emprovement of Percutaneous Puncture Core Renal Biopsy in Diffuse Diseases
We developed methods to improve ultrasound-guided percutaneous renal puncture core biopsy in diffuse diseases. The use of semi-automatic needles True-Cut, caliber 14G, with harpoon-type mandrin, which enables to obtain high-quality tissue samples, up to 2 cm in length and up to 1.2 mm in thickness that makes it possible to perform a single tissue retrieval (2–3 — in exceptional cases). 40 patients underwent “free hand” biopsy using semi-automatic needles. The peculiarity of the suggested technique of biopsy needle visualization improvement is in the creation of induced anechoic space in paranephral cellular tissue by means of tissue infiltration by 0.25% novocaine solution. It helps to localize the tip of a mandrin immediately close to the renal surface and enables its controlled introduction into the selected biopsy area. To avoid the calices-pelvis system or vessel damage, the approach is along the line going obliquely superiorly down through parenchyma of the middle third of the kidney towards the lower pole at sufficient distance from the renal sinus echostructures. Informative material for histological study was obtained without complications in all cases. The optimized biopsy technique permits early activization of patients and their reduced (up to one day) stay in hospital.
- Nefrologiya [Nephrology]. Pod red. Shilova E.M. [Shilov E.M. (editor)]. Moscow: GEOTAR-Media; 2010; 712 p.
- Silverman S.G., Gan Y.U., Mortele K.J., Tuncali K., Cibas E.S. Renal masses in the adult patient: the role of percutaneous biopsy. Radiology 2006; 240(1): 6–22.
- Toropilov D.M., Shein I.A., Lakisov P.P. Opyt primeneniya punktsionnoy nefrobiopsii na baze Vitebskoy oblastnoy klinicheskoy nefrologicheskoy bol'nitsy. V kn.: Materialy konferentsii k 10-letnemu yubileyu Vitebskogo diagnosticheskogo tsentra «Sovremennye podkhody i vnedrenie novykh metodov v diagnostike» [The experience in puncture nephrobiopsy application on the basis of Vitebsk Regional Clinical Nephrological Hospital. In: Proceeding of the conference “Modern approaches and implementation of new diagnostic techniques” for the 10th anniversary of Vitebsk diagnostic centre]. Vitebsk; 2005. P. 212–215.
- Hergesell O., Felten H., Andrassy K., Kuhn K., Ritz E. Safety of ultrasound-guided percutaneous renal biopsy — retrospective analysis of 1090 consecutive cases. Nephrol Dial Transplant 1998; 13(4): 975–977.
- Naumovic R., Pavlovic S., Stojkovic D., Basta-Jovanovic G., Nesic V. Renal biopsy registry from a single centre in Serbia: 20 years of experience. Nephrol Dial Transplant 2009; 24(3): 877–885.
- Gesualdo L., Cormio L., Stallone G., Infante B., Di Palma A.M., Delli Carri P., et al. Percutaneous ultrasound-guided renal biopsy in supine antero-lateral position: a new approach for obese and non-obese patients. Nephrol Dial Transplant 2008; 23(3): 971–976.
- Pasquariello A., Innocenti M., Batini V., Pasquariello G., Beati S., Rindi S., et al. Theoretical calculation of optimal depth in the percutaneous native kidney biopsy to drastically reduce bleeding complications and sample inadequacy for histopathological diagnosis. Nephrol Dial Transplant 2007; 22(12): 3516–3520.
- Kapustin S.V., Ouen R., Pimanov S.I. Ul’trazvukovoe issledovanie v urologii i nefrologii [Ultrasound investigation in urology and nephrology]. Minsk; 2007; 170 p.
- Waldo B., Korbet S.M., Freimanis M.G., Lewis E.J. The value of post-biopsy ultrasound in predicting complications after percutaneous renal biopsy of native kidneys. Nephrol Dial Transplant 2009; 24(8): 2433–2439.
