A randomized controlled trial of procedural techniques for large volume paracentesis



Document title: A randomized controlled trial of procedural techniques for large volume paracentesis
Journal: Annals of hepatology
Database: PERIÓDICA
System number: 000409389
ISSN: 1665-2681
Authors: 1
1
1
2
1
1
Institutions: 1University of Virginia, Division of Gastroenterology and Hepatology, Charlottesville, Virginia. Estados Unidos de América
2University of Virginia, School of Medicine, Charlottesville, Virginia. Estados Unidos de América
Year:
Season: Mar-Abr
Volumen: 16
Number: 2
Pages: 279-284
Country: México
Language: Inglés
Document type: Estadística o encuesta
Approach: Analítico
English abstract The aim of this study is to investigate large volume therapeutic paracentesis using either a z-tract or axial (coxial) technique in a randomized controlled trial. Materials and methods. This randomized, single blind study, patients with cirrhosis undergoing outpatient therapeutic paracentesis were randomized to the z-tract or the modified angular (coaxial) needle insertion technique. Subject and procedure characteristics were compared between the groups with ascites leakage as quantified by need for dressing changes with standardized sized gauze pads as a primary endpoint and subject procedural discomfort, operator preference, and procedure complications as secondary endpoints. Results. 72 paracenteses were performed during the study period: 34 to the z-tract and 38 to the coaxial insertion technique. Following exclusions, a total of 61 paracenteses were analyzed: 30 using the z-tract technique and 31 using the coaxial technique. There were equal rates of post-procedural leakage of ascites between groups (13% in both groups, p = 1.00). Using the visual analog scale (0 - 100), there was a statistically significant increase in the subject reported pain score with the z-tract compared with the coaxial method [26.4 (95% CI 18.7 - 34.1) vs. 17.2 (95% CI 10.6 - 23.8), p = 0.04]. Mean physician rated procedure difficulty (1 - 5) was significantly higher for the z-tract vs. the coaxial technique [2.1 (95% CI 1.6 - 2.6) vs. 1.5 (95% CI 1.2 - 1.8), p = 0.04]. Conclusion. When compared to the z-tract technique, the coaxial insertion technique is superior during large volume paracentesis in cirrhosis patients
Disciplines: Medicina
Keyword: Gastroenterología,
Terapéutica y rehabilitación,
Ascitis,
Cirrosis,
Procesos invasivos,
Complicaciones,
Peritonitis,
Paracentesis,
Técnicas quirúrgicas
Keyword: Medicine,
Gastroenterology,
Therapeutics and rehabilitation,
Ascites,
Cirrhosis,
Invasive processes,
Complications,
Peritonitis,
Paracentesis,
Surgical techniques
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