Specimens were obtained by using a single pass of the TC needle through the tissue. This resulted in 7 groups with 12 biopsy specimens obtained for each group. Overall, 84 biopsy specimens were obtained in the animal model and were sent for histology assessment. Vorinostat To test whether practical application of the cryoprobe introduced through an echoendoscope is feasible in humans by using classical echoendoscope positions such as in the stomach, pancreatic organ biopsy specimens were obtained in two recently deceased human cadavers (<72 hours postmortem), (1) through laparotomy puncture by using each
technique (CB, EUS-FNA, and TC) and (2) with standard EUS equipment by using an Olympus GF-UCT140-AL5 (Evis Exera II, Olympus, Hamburg, Germany) echoendoscope with an ALOKA processor (ProSound Alpha 10; Aloka Europe, Zug, Switzerland). The latter experiments were performed to assess maneuverability and handling of selleck products the EUS-guided CB. Specimens were obtained via transgastric puncture from the pancreatic body. Specimens were obtained by using a single pass of the cryoprobe needle through the tissue. This resulted in 5 groups with 12 biopsy specimens obtained for each group.
All biopsy specimens were assessed by a pathologist who was blinded to the biopsy method. Size of the specimen, presence of artifacts, and histopathologic assessability were evaluated by using a 7-point Likert scale (Fig. 2) developed for this study. Histopathologic assessability was considered the primary outcome parameter. We used a Likert scale with anchor points at 0, 2, 4, and 6; numbers 1, 3, and 5 represent interim values in between the anchor points.15 Measurement of the formalin-fixed, gross core was performed by using a ruler. In addition, the pathologist measured the paraffin-embedded core under his microscope ocular metric. Directly after puncture of the pancreas, a timer was started. A gauze was used to wipe fresh blood from the puncture site PIK3C2G every 3 seconds. Time until spontaneous cessation of bleeding was documented after each biopsy. Technical feasibility of CB was assessed for friction
between the probe and the channel, maneuverability, and macroscopic reliable specimen retrieval in the porcine and cadaver models. This was a subjective outcome evaluation by 3 investigators (D.vR., T.R., U.D.). Data were analyzed with descriptive statistics (median and interquartile ranges [IQR]). For bleeding times, biopsy size, artifacts, and histologic assessability, a 1-way analysis of variance test (Kruskal-Wallis) was used. The Dunn multiple comparison test was applied to compare pairs of group means. A P value < .05 was considered statistically significant. All P values are 2-sided and were not adjusted for the number of parameters evaluated. This study was the first trial evaluating the novel cryoprobe.