Transthoracic approach for liver tumors

Golse, Nicolas; Ducerf, C.; Rode, Agnès; Gouillat, C.; Baulieux, J.; Mabrut, Jean‐Yves

doi:10.1016/j.jviscsurg.2011.10.009

Cited by 14 publications

(7 citation statements)

References 44 publications

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“…Likewise air-containing structures and bones are not penetrated by ultrasound waves, making structures located within or behind them inaccessible via US guidance. In the majority of these situations, CT guidance will provide the means for biopsy or drainage [7–9]. Other guidance techniques such as fluoroscopy and MRI have been reported.…”

Section: Discussionmentioning

confidence: 99%

CT-guided procedures: an initial experience

Roman

Achimaș-Cădariu

Fetică

et al. 2018

Medicine and Pharmacy Reports

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Background and aimsDespite their usefulness, CT-guided procedures have a low profile in Romania. The current study has the purpose of describing a first experience in performing these procedures.MethodsTumors and fluid collections that were inaccessible for biopsy or drainage by ultrasound or endoscopic guidance were included. The procedures were performed using a 64-slice GE Optima CT660 CT scanner. The biopsies were carried out using the coaxial technique with an 18 G semiautomatic needle. The drainages were performed using 10 F pig-tail drains that were inserted using the Seldinger technique. Data regarding the size and location of the target lesion, puncture technique, success and complication rates were recorded.ResultsBetween May 2017 and April 2018, 30 procedures were performed, of which 26 biopsies and 4 drainage insertions. Of the biopsies 3 were mediastinal, 8 pulmonary, 6 retroperitoneal, 4 pelvic, and 5 of the bone. The drainages were performed for pelvic lymphoceles. The average lesion size was 3.2 cm (0.7–9 cm), with a depth from the skin of 9.1 cm (0.6–15.2 cm). The average procedure duration was 58 minutes (31–93 minutes). A conclusive histopathological diagnosis was set after 92.3% of biopsies. Three procedures resulted in complications, two being minor (hemothorax, soft tissue hematoma) and one severe (tension pneumothorax requiring drainage).ConclusionsCT guidance offers safe access to lesions that cannot be biopsied or drained under ultrasound or endoscopic guidance.

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Section: Discussionmentioning

confidence: 99%

CT-guided procedures: an initial experience

Roman

Achimaș-Cădariu

Fetică

et al. 2018

Medicine and Pharmacy Reports

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“…Regarding tissue sampling procedures, both NCB and FNAB are minimally invasive techniques, that can be used in order to obtain sufficient tissue fragments for the cytopathological examination and ancillary tests such as molecular studies and cytogenetics, polymerase chain reaction (PCR), fluorescent in situ hybridization (FISH), flow cytometry, and microbiological evaluation (6). FNAB started to be used more frequently in the 1950s, especially in the evaluation process of breast masses, in spite of the fact that it was first reported in the beginning of the 1930s (7,8). The core needle biopsy technique was introduced much later, in the 1990s and it has become more popular due to its several advantages compared to FNAB: it has higher sensitivity and specificity than FNAB, it permits an accurate differentiation between benign and malignant tumors, as well as the distinction between invasive tumors and in situ carcinoma (8).…”

Section: Minimally Invasive Biopsy In Retroperitoneal Tumors (Review)mentioning

confidence: 99%

“…FNAB started to be used more frequently in the 1950s, especially in the evaluation process of breast masses, in spite of the fact that it was first reported in the beginning of the 1930s (7,8). The core needle biopsy technique was introduced much later, in the 1990s and it has become more popular due to its several advantages compared to FNAB: it has higher sensitivity and specificity than FNAB, it permits an accurate differentiation between benign and malignant tumors, as well as the distinction between invasive tumors and in situ carcinoma (8). FNAB, image-guided or not (for palpable, superficial tumors), is a fast, low cost, simple and accessible procedure.…”

Section: Minimally Invasive Biopsy In Retroperitoneal Tumors (Review)mentioning

confidence: 99%

Minimally invasive biopsy in retroperitoneal tumors (Review)

et al. 2019

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Minimally invasive biopsy procedures have proven over the years to be essential for obtaining a correct diagnosis of retroperitoneal tumors, that allows proper therapeutical conduct. These procedures offer valuable tissue fragments for histopathological examination, that permits the distinction between benign and malignant tumors, identifying the tumors that can benefit from neo-adjuvant treatments, such as chemotherapy or radiotherapy and those that have a direct surgical indication. We have searched the existing data regarding minimally invasive biopsy in retroperitoneal tumors using the PubMed database, in order to evaluate the role of this procedure in establishing a correct diagnosis, as well as to find out the risks of tumor cell seeding and local recurrence after needle biopsy. The risk of tumor cell seeding is very low (<2%) and in some cases, it is considered negligible (<0.5%). Compared to open biopsy, needle biopsy seems to be associated with a significantly lower risk of tumor cell seeding. According to the existing data, the incidence of needle track tumor cell seeding also depends on the histological type of the tumors. Image-guided retroperitoneal biopsy has proven to be low cost, accessible, and a reliable procedure (in terms of diagnostic accuracy), usually associating with a low rate of complications and a low risk of tumor seeding. Several authors have underlined the importance of the retroperitoneal approach and the association with a co-axial imaging technique in order to avoid potentially deadly complications. Contents 1. Introduction 2. Image-guided tumor biopsy 3. Biopsy techniques 4. Risk of tumor cell seeding using biopsy techniques 5. Conclusions

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“…Iatrogenic pneumothorax: An iatrogenic pneumothorax can be created when other approaches fail[37,38]. In this technique, an 18 gauge epidural needle is appropriately positioned in the pleural space and around 50 mL of air, obtained through a micro-porous filter, is injected into the pleural space.…”

Section: Hepatic Dome Interventions: Tips and Tricksmentioning

confidence: 99%

Imaging guided percutaneous interventions in hepatic dome lesions: Tips and tricks

Kambadakone¹,

Baliyan²,

Kordbacheh³

et al. 2017

WJH

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Percutaneous hepatic interventions are generally safe given the fact that liver closely abuts the abdominal wall and hence it is easily accessible. However, the superior portion of liver, adjacent to the diaphragm, commonly referred as the “hepatic dome”, presents unique challenges for interventionists. Percutaneous access to the hepatic dome may be restricted by anatomical factors and special considerations may be required to avoid injury to the surrounding organs. The purpose of this review article is to discuss certain specific maneuvers and techniques that can enhance the success and safety of interventions in the hepatic dome.

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Transthoracic approach for liver tumors

Cited by 14 publications

References 44 publications

CT-guided procedures: an initial experience

CT-guided procedures: an initial experience

Minimally invasive biopsy in retroperitoneal tumors (Review)

Imaging guided percutaneous interventions in hepatic dome lesions: Tips and tricks

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