A MODIFIED ABRAMS NEEDLE-BIOPSY TECHNIQUE

Study objective: To compare the diagnostic sensitivity of a modified A brams needle pleural biopsy technique (A1) with the standard Abrams (A 2) and Cope needle biopsy methods. The modified Abrams pleural biopsy technique consisted of suctioning each tissue sample into a syringe wi thout removing the needle completely from the chest until the completi on of the entire procedure, Both the standard Abrams and Cope needle t echniques required needle removal from the chest after each pleural bi opsy. Design: Retrospective chart analysis. Setting: Community teachin g hospital affiliated with Stanford University. Patients: Forty-seven patients (30 men and 17 women) with a mean age of 44.5 years (range, 1 9 to 81 years) who were referred to a pulmonary consultation service f or pleural biopsy. Interventions: Two of us (C.M.K. and F.T.K.) used t he modified Abrams technique and two of us (W.A.J. and A.C.C.) used th e standard Abrams technique, The Cope needle was used as originally de scribed. Measurements: We recorded the type of pleural biopsy needle a nd technique used in each patient. Biopsy specimen diameter and number of tissue samples obtained, final diagnoses, and complications were r ecorded. Results: The diagnostic sensitivity for tuberculous pleurisy was 82% for the modified Abrams method, 71% for the standard Abrams me thod, and 88% for the standard Cope technique (p greater than or equal to 0.3). There was no difference, in size of tissue sample obtained ( A1 vs A2), number of biopsies, or complications among the three method s of pleural biopsy. Conclusions: The modified method of Abrams needle biopsy demonstrates a diagnostic sensitivity for pleural tuberculosis (82%) that is equivalent to that for the standard Abrams or Cope meth ods.