Comparison of efficacy and safety between negative pressure suction puncture and biopsy-gun puncture in ultrasound-guided percutaneous renal needle biopsy

Abstract

Objective To compare the efficacy and safety of different percutaneous renal needle biopsy methods. Methods Total 453 patients underwent renal needle biopsy in Taizhou Central Hospital during June 2009 and December 2014, including 221 patients received ultrasound-guided negative pressure suction puncture and 232 patients received ultrasound-guided biopsy gun puncture. The glomerular filtration rates (GFRs) were measured with single photon computed tomography [ECT (99mTc-DTPA)] before and after renal puncture. The amount of glomeruli obtained and incidence of perirenal hematoma were documented and compared between two groups. Results GFRs of punctured renal in negative pressure group were(37.7±11.6)ml/min before puncture and(38.3±11.7)ml/min after puncture (t=0.485, P=0.628); those in biopsy gun group were(36.8±11.3)ml/min before puncture and(37.4±11.9)ml/min after puncture (t=0.565, P=0.572). The incidence of perirenal hematoma >5 cm and ≤5 cm was 5.3%(24/453) and 6.0% (27/453), respectively. In hematoma >5cm group the GFR was decreased from(37.5±10.7)ml/min before renal puncture to(33.5±10.1)ml/min after puncture (t=2.103, P=0.038). The amount of glomeruli obtained by negative pressure puncture and by biopsy gun puncture was 26.4±15.9 and 20.6±9.9, respectively (t=4.648, P=0.000). The incidence of perirenal hematoma in negative pressure and biopsy gun groups was 6.8% (15/221) and 15.5% (36/232), respectively (χ2=8.634, P=0.003). The successful rate of renal needle biopsy in biopsy gun group was significant higher than that in negative pressure group [98.7±7.5% vs. 61.4±25.8%, t=5.453, P=0.000]. Conclusions The large hematoma in punctured kidney would reduce the GFR in short-time. Negative pressure suction puncture may obtain more glomeruli and have lower incidence of perirenal hematoma, but have lower successful rate of renal needle biopsy. Key words: Biopsy, needle; Kidney; Glomerular filtration rate; Hematoma