title: A sequential comparison on the risk of haemorrhage with different sizes of biopsy needles for stereotactic brain biopsy.
abstract: OBJECTIVE
  To compare the risk of postoperative haemorrhage with different sizes of brain biopsy needles.
  
  
  METHODS
  A cohort of patients using a 2.5-mm outer diameter side-cutting biopsy needle was compared to a subsequent cohort using a 1.8-mm needle of the same type. All data were collected prospectively. A CT scan was done within 12 h after surgery. Any visible haemorrhage at the operated site was documented.
  
  
  RESULTS
  From 2007 to 2013, 54 stereotactic brain biopsies (all frameless except for one frame-based) were performed. The 2.5-mm group comprised 29 procedures from 2007 to 2009. The 1.8-mm group comprised the subsequent 25 procedures. The diagnostic yields were 90 and 96% in the 2.5- and the 1.8-mm group, respectively (p = 0.615). Comparing the 2.5- and the 1.8-mm group, haemorrhage was significantly reduced: incidence (72 vs. 40%, p = 0.016); size of haemorrhage (mean 7.2 vs. 2.6 mm, p = 0.002); proportion of haemorrhage size >10 mm (34.5 vs. 4%, p = 0.006). Symptomatic haemorrhage rates were 3.4 and 0.0% in the 2.5- and the 1.8-mm group, respectively (p = 1.00).
  
  
  CONCLUSIONS
  The 1.8-mm outer diameter needle carried a lower risk of postoperative haemorrhage than the 2.5-mm one, without compromising the diagnostic yield.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, SAR, China.
authors.forename: Jason
authors.initials: J
authors.lastname: Yuen
authors.forename: Cannon X L
authors.initials: CX
authors.lastname: Zhu
authors.forename: Danny T M
authors.initials: DT
authors.lastname: Chan
authors.forename: Rebecca Y T
authors.initials: RY
authors.lastname: Ng
authors.forename: Wai
authors.initials: W
authors.lastname: Nia
authors.forename: Wai Sang
authors.initials: WS
authors.lastname: Poon
authors.forename: Ho Keung
authors.initials: HK
authors.lastname: Ng
authors.forename: Vincent C T
authors.initials: VC
authors.lastname: Mok
authors.forename: Laurence K S
authors.initials: LK
authors.lastname: Wong
authors.forename: Tom C Y
authors.initials: TC
authors.lastname: Cheung
authors.forename: Deyond Y W
authors.initials: DY
authors.lastname: Siu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000592:standards*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D013238:Stereotaxic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D055815:Young Adult