Combination use of gelatin sponge particles and thrombin solution injection for the prevention of needle tract bleeding after CT-guided biopsy of ovarian cancer

Objective: To discuss the clinical value of combination use of gelatin sponge particles and thrombin solution injection in preventing needle tract bleeding after CT-guided biopsy of ovarian carcinoma. Methods: CT-guided puncturing biopsy of ovarian carcinoma was performed in 65 patients with clinically-suspected advanced ovarian cancer, and all the procedures were accomplished by the same working group. According to the closing way of the needle tract, the patients were randomly divided into group A (n = 30, using thrombin solution injection to close the needle tract) and group B (n = 35, using gelatin sponge particles plus thrombin solution injection to close the needle tract). The operation time and incidence of needle tract bleeding after the closure of needle tract were compared between the two groups. Results: Biopsy sampling was successfully accomplished in all 65 patients. Pathological diagnoses included primary ovarian cancer (n = 49) and ovarian metastatic carcinoma (n = 16). In group A,the mean operation time and needle tract bleeding rate within 3 min after thrombin injection were 33.6 min and 13.3% (4/30) respectively; and at 5 min after thrombin injection hemostasis was achieved in all patients. In group B, the mean operation time was 30.4 min, and no needle tract bleeding was observed at 3 min after the closure of needle tract in all patients. The differences in the mean operation time and 3-min needle tract bleeding rate between the two groups were statistically significant (t = 4.315, P < 0.05; χ² = 4.973, P < 0.05). After the procedure, all patients were kept under close observation for 48 hours, and no adverse reactions were observed. During the follow-up period lasting for 3 months no delayed complications such as hemorrhage due to tumor rupture occurred. Conclusion: CT-guided puncturing biopsy of ovarian tumors is minimally-invasive, accurate and safe. In comparison with simple use of thrombin solution injection, combination use of gelatin sponge particles and thrombin can more quickly and effectively prevent needle tract bleeding. (authors)