Biopsy procedureLocalization of the

Biopsy procedure
Localization of the mass was determined by CT or positron emission tomography (PET) CT. The shortest and safest parenchyma distance to reach the lesion was determined. The distance of the lesion from the entry point and entry angle were planned and the entry point on the skin was marked by a permanent marker (Fig.). The distance between skin, pleura, and lesion were also measured and recorded. Marked skin entry site and the surrounding area were cleaned with povidone iodine solution. Skin was covered with sterile drapes exposing only the entry site. Local anesthesia of the skin and subcutaneous tissues was achieved with 5–10 cc of lidocaine HCl. In accordance with the predetermined route, a 17G, 11 cm coaxial needle guide (Matek 17GKN11, Matek medical, Ankara, Turkey) was advanced in the skin until “skin-pleura” distance, and control CT sections were acquired. After ensuring that the route of the needle was in the proper position, it was advanced rapidly to pass through the pleura in one swift move and control CT sections were obtained to confirm the appropriate position of the needle within the lesion. The correct localization of the needle was verified by using the following criteria such as the needle’s tip being inside or on the edge of the lesion and seeing linear hypodensity extending peripheral to the needle tip (beam hardening artifact). The inner chuck of coaxial needle guide was removed and an 18G, 16 cm core semi-automatic core biopsy pistol (Matek medical) was placed inside the needle guide. After obtaining the sample, the needle was carefully removed from the cannula and the chuck was reattached. To acquire multiple samples, the needle guide was not removed from the lesion and the material acquisition was repeated by directing the biopsy pistol into appropriate positions at different directions. The materials obtained by core biopsy were put into previously prepared sterile 10% formalin solution. Fine-needle aspiration materials were sprayed onto the slide and were quickly and carefully spread to avoid crushing of the cells and placed into a previously prepared vessel containing 95% ethyl alcohol. Part of the smear samples was allowed to air dry. The biopsy system was withdrawn when sufficient biopsy materials were collected. The needle entry site was sealed with antibiotic ointment and sterile gauze, and axial slices were taken at the biopsy level without lifting the patient. Patient was transferred to observation room, positioned so that the needle entry remained underneath, and followed for two hours for possible complications. Asymptomatic patients with mild pneumothorax were followed with no intervention. Chest tubes were inserted into symptomatic patients and patients with evidence of increasing pneumothorax, based on control postero-anterior chest radiographs or CT scans.

Hasil (Melayu) 2:

Biopsi prosedur
Localization jisim ditentukan oleh CT atau positron pelepasan tomografi (PET) CT. Jarak parenchyma terpendek dan paling selamat untuk sampai ke lesi ditentukan. Jarak lesi dari pintu masuk dan kemasukan sudut telah dirancang dan pintu masuk pada kulit ditandai dengan penanda kekal (Gamb.). Jarak antara kulit, pleura, dan luka juga diukur dan direkodkan. Ketara tapak kemasukan kulit dan kawasan sekitarnya telah dibersihkan dengan larutan povidone iodin. Kulit telah ditutup dengan langsir steril mendedahkan tapak sahaja penyertaan. Anestesia tempatan kulit dan tisu subkutaneus dicapai dengan 5-10 cc lidocaine HCl. Mengikut laluan yang telah ditetapkan, yang 17g, 11 cm sepaksi panduan jarum (Matek 17GKN11, Matek perubatan, Ankara, Turki) telah maju dalam kulit sehingga "kulit-pleura" jarak, dan kawalan bahagian CT telah diperolehi. Selepas memastikan bahawa laluan jarum itu berada pada kedudukan yang betul, ia maju dengan pantasnya untuk melalui pleura dalam satu langkah yang pantas dan mengawal bahagian CT diperolehi untuk mengesahkan kedudukan yang betul jarum dalam lesi. Penyetempatan betul jarum telah disahkan dengan menggunakan kriteria berikut seperti hujung jarum yang di dalam atau di pinggir lesi dan melihat hypodensity linear melanjutkan periferal ke hujung jarum (rasuk pengerasan artifak). The chuck dalaman panduan jarum sepaksi telah dibuang dan 18G, 16 cm teras separa automatik pistol teras biopsi (Matek perubatan) telah diletakkan di dalam panduan jarum. Selepas mendapat sampel, jarum itu dengan teliti dikeluarkan daripada kanula dan chuck itu reattached. Untuk memperoleh beberapa sampel, panduan jarum itu tidak dikeluarkan dari lesi dan pemerolehan bahan diulangi dengan mengarahkan pistol biopsi ke dalam kedudukan yang sesuai di arah yang berbeza. Bahan-bahan yang diperolehi dengan teras biopsi telah dimasukkan ke dalam disediakan sebelum ini steril 10% larutan formalin. Bahan aspirasi jarum halus telah disembur ke slaid dan telah dengan cepat dan berhati-hati untuk mengelakkan merebak menghancurkan sel-sel dan diletakkan ke dalam bekas yang disediakan sebelum ini yang mengandungi 95% alkohol etil. Sebahagian daripada sampel calitan dibenarkan udara kering. Sistem biopsi telah ditarik balik apabila bahan biopsi mencukupi telah dikumpulkan. Tapak masuk jarum telah dimeteraikan dengan salap antibiotik dan kain kasa steril, dan keping paksi telah diambil di peringkat biopsi tanpa mengangkat pesakit. Pesakit telah dipindahkan ke bilik pemerhatian, kedudukan supaya masuk jarum kekal di bawah, dan diikuti selama dua jam untuk komplikasi yang mungkin. Pesakit asimptomatik dengan pneumothorax ringan diikuti tanpa campur tangan. Tiub dada dimasukkan ke dalam gejala pesakit dan pesakit dengan bukti yang semakin meningkat pneumothorax, berdasarkan kawalan postero-anterior radiograf dada atau imbasan CT.