Puncture needle with a hard plastic sheath and plastic wings minimizes repuncture attempts in ultrasound-guided paracentesis: a retrospective case-control study
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: This study was performed to evaluate periprocedural factors, complications, and repuncture rate of the newly developed puncture needle and compare it with the routinely used puncture needle for ultrasound (US)-guided paracentesis. Methods: We retrospectively identified 137 patients who underwent US-guided paracentesis between July 2018 and March 2019. Among them, 82 patients underwent US-guided paracentesis with a newly developed puncture needle. The other 55 patients underwent US-guided paracentesis with a routinely used puncture needle. The periprocedural factors, complications, and repuncture rate were compared between the two groups using the Mann-Whitney U test and Fisher exact test. The repuncture-associated factors were assessed using logistic regression analysis. Results: There were no major or minor complications in either group. The rate of repuncture was significantly lower in the group using the newly developed puncture needle compared with the group using the routinely used puncture needle (p=0.01). The duration of the procedure was significantly shorter with the newly developed puncture needle compared with the routinely used puncture needle (p=0.01). In univariate analysis, the thickness of the abdominal wall (p=0.04) and the use of the newly developed puncture needle (p=0.01) were significantly associated with the rate of repuncture. In multivariate analysis, only the use of the newly developed puncture needle was significantly associated with the rate of repuncture. Conclusion: Using this novel puncture needle with a hard plastic sheath and plastic wings, the rate of repuncture and the duration of the procedure were decreased without complications of US-guided paracentesis.
Abstract
Background: This study was performed to evaluate periprocedural factors, complications, and repuncture rate of the newly developed puncture needle and compare it with the routinely used puncture needle for ultrasound (US)-guided paracentesis. Methods: We retrospectively identified 137 patients who underwent US-guided paracentesis between July 2018 and March 2019. Among them, 82 patients underwent US-guided paracentesis with a newly developed puncture needle. The other 55 patients underwent US-guided paracentesis with a routinely used puncture needle. The periprocedural factors, complications, and repuncture rate were compared between the two groups using the Mann-Whitney U test and Fisher exact test. The repuncture-associated factors were assessed using logistic regression analysis. Results: There were no major or minor complications in either group. The rate of repuncture was significantly lower in the group using the newly developed puncture needle compared with the group using the routinely used puncture needle (p=0.01). The duration of the procedure was significantly shorter with the newly developed puncture needle compared with the routinely used puncture needle (p=0.01). In univariate analysis, the thickness of the abdominal wall (p=0.04) and the use of the newly developed puncture needle (p=0.01) were significantly associated with the rate of repuncture. In multivariate analysis, only the use of the newly developed puncture needle was significantly associated with the rate of repuncture. Conclusion: Using this novel puncture needle with a hard plastic sheath and plastic wings, the rate of repuncture and the duration of the procedure were decreased without complications of US-guided paracentesis.
참고문헌 (22)
- European Association for the Study of the Liver, "EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis", J Hepatol, 53, pp.397~417 (2010)
- 황보영, "천자검사를 받은 복수 환자의 원인 분석", Clinical and Molecular Hepatology, 13(2), pp.185~195 (2007), 대한간학회
- Ginés P, "Compensated cirrhosis : natural history and prognostic factors", Hepatology, 7, pp.122~128 (1987)
- Moore KP, "The management of ascites in cirrhosis : report on the consensus conference of the International Ascites Club", Hepatology, 38, pp.258~266 (2003)
- Runyon BA, "The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites", Ann Intern Med, 117, pp.215~220 (1992)
- al Karawi MA, "Protean manifestation of gastrointestinal tuberculosis : report on 130 patients", J Clin Gastroenterol, 20, pp.225~232 (1995)
- Runyon BA, "Management of adult patients with ascites due to cirrhosis : an update", Hepatology, 49, pp.2087~2107 (2009)
- Poonawala A, "Prevalence of obesity and diabetes in patients with cryptogenic cirrhosis : a case-control study", Hepatology, 32(4 Pt 1), pp.689~692 (2000)
- DeSitter L, "The significance of bloody ascites in patients with cirrhosis", Am J Gastroenterol, 79, pp.136~138 (1984)
- Runyon BA, "The opacity of portal hypertension-related ascites correlates with the fluid’s triglyceride concentration", Am J Clin Pathol, 96, pp.142~143 (1991)
- Moore KP, "Guidelines on the management of ascites in cirrhosis", Gut, 55(Suppl 6), pp.vi1~vi12 (2006)
- Evans TW, "Review article : albumin as a drug. Biological effects of albumin unrelated to oncotic pressure", Aliment Pharmacol Ther, 16(Suppl 5), pp.6~11 (2002)
- Cho J, "Recommendations on the use of ultrasound guidance for adult abdominal paracentesis : a position statement of the Society of Hospital Medicine", J Hosp Med, 14, pp.E7~E15 (2019)
- Omary RA, "Quality improvement guidelines for the reporting and archiving of interventional radiology procedures", J Vasc Interv Radiol, 14(9 Pt 2), pp.S293~S295 (2003)
- Tirkes T, "Peritoneal and retroperitoneal anatomy and its relevance for cross-sectional imaging", Radiographics, 32, pp.437~451 (2012)
- Churg A, "Tumors of the serosal membranes" (2006), American Registry of Pathology;
- Hanbidge AE, "US of the peritoneum", Radiographics, 23, pp.663~684 (2003)
- Runyon BA, "Paracentesis of ascitic fluid. A safe procedure", Arch Intern Med, 146, pp.2259~2261 (1986)
- McVay PA, "Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities", Transfusion, 31, pp.164~171 (1991)
- Pache I, "Severe haemorrhage following abdominal paracentesis for ascites in patients with liver disease", Aliment Pharmacol Ther, 21, pp.525~529 (2005)
- Mercaldi CJ, "Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis", Chest, 143, pp.532~538 (2013)
- Patel PA, "Evaluation of hospital complications and costs associated with using ultrasound guidance during abdominal paracentesis procedures", J Med Econ, 15, pp.1~7 (2012)