Cryobiopsy in the Upper Urinary Tract: Preclinical Evaluation of a Novel Device
| Autor: | Luise Jäger, Hans Bösmüller, J. Mundhenk, Christian Schwentner, Christian Bolenz, Jan-Thorsten Klein, Franziska Berger, Walter Linzenbold, Markus D. Enderle |
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| Rok vydání: | 2019 |
| Předmět: |
Standard of care
Swine Biopsy Urology Forceps 030232 urology & nephrology Diagnostic accuracy Kidney Cryosurgery Deflection angle 03 medical and health sciences 0302 clinical medicine Animals Medicine Biopsy methods Upper urinary tract medicine.diagnostic_test business.industry Kidney pathology Equipment Design 030220 oncology & carcinogenesis Feasibility Studies Ureter business Nuclear medicine |
| Zdroj: | Urology. 123:273-279 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2018.10.003 |
| Popis: | OBJECTIVE To develop a novel device for cryobiopsy of the upper urinary tract (UUT) and to evaluate its feasibility in a standardized preclinical setting. MATERIALS AND METHODS Flexible cryoprobes (diameter 0.9 mm; cooling agent CO2) were developed and used to extract biopsies in porcine UUTs. Cryosamples obtained by ureterorenoscopy were systematically compared with biopsy specimens obtained with standard of care devices in terms of physical characteristics (deflection angle and irrigation flow rates) and histologic criteria (assessability). RESULTS Irrigation flow rates were significantly higher with introduced BIGopsy (2.8 ± 0.1) compared with standard forceps (0.94 ± 0.06; P < .001) and cryoprobe (1.1 ± 0.1; P < .001). Angular deflection was significantly reduced by the inserted cryoprobe (130.7° ± 1.2° vs 166.9° ± 1.1° [BIGopsy] or 161.4° ± 1.9° [standard forceps]; both P < .001). Significantly larger UUT tissue samples were obtained by the cryoprobe (mean specimen area 7.5 ± 2.5 vs 4.6 ± 2.5 mm² [BIGopsy] or 1.4 ± 1.4 mm² [standard forceps]; both P < .001). No crush artifacts were observed in cryosamples. Superior histologic assessability scores were achieved in samples obtained by the cryoprobe (mean 2.8 ± 0.8) and BIGopsy (2.3 ± 1.9) when compared with standard forceps (0.4 ± 0.9; P < .001). CONCLUSION Cryobiopsy in the UUT is feasible and represents a viable new option to improve the diagnostic accuracy of histopathologic evaluation. Larger and more representative tissue samples can be obtained using a cryoprobe and artifacts may be avoided. Further optimization of the probe will reduce possible restrictions of ureterorenoscopy handling when the device is inserted. |
| Databáze: | OpenAIRE |
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