A Modified Abrams Needle Biopsy Technique

Study objective To compare the diagnostic sensitivity of a modified Abrams needle pleural biopsy technique (Al) with the standard Abrams (A2) and Cope needle biopsy methods. The modified Abrams pleural biopsy technique consisted of suctioning each tissue sample into a syringe without removing the needle completely from the chest until the completion of the entire procedure. Both the standard Abrams and Cope needle techniques required needle removal from the chest after each pleural biopsy. Design Retrospective chart analysis. Setting Community teaching hospital affiliated with Stanford University. Patients Forty-seven patients (30 men and 17 women) with a mean age of 44.5 years (range, 19 to 81 years) who were referred to a pulmonary consultation service for pleural biopsy. Interventions Two of us (C.M.K. and F.T.K.) used the modified Abrams technique and two of us (W.A.J. and A.C.C.) used the standard Abrams technique. The Cope needle was used as originally described. Measurements We recorded the type of pleural biopsy needle and technique used in each patient. Biopsy specimen diameter and number of tissue samples obtained, final diagnoses, and complications were recorded. Results The diagnostic sensitivity for tuberculous pleurisy was 82% for the modified Abrams method, 71% for the standard Abrams method, and 88% for the standard Cope technique (p≥0.3). There was no difference in size of tissue sample obtained (Al vs A2), number of biopsies, or complications among the three methods 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 methods.