<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-2681</journal-id>
<journal-title><![CDATA[Annals of Hepatology]]></journal-title>
<abbrev-journal-title><![CDATA[Ann. Hepatol.]]></abbrev-journal-title>
<issn>1665-2681</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Hepatología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-26812017000200279</article-id>
<article-id pub-id-type="doi">10.5604/16652681.1231587</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[A Randomized Controlled Trial of Procedural Techniques for Large Volume Paracentesis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Shriver]]></surname>
<given-names><![CDATA[Amy R.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rudnick]]></surname>
<given-names><![CDATA[Sean R.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Intagliata]]></surname>
<given-names><![CDATA[Nicolas M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Amanda M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caldwell]]></surname>
<given-names><![CDATA[Stephen H.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Northup]]></surname>
<given-names><![CDATA[Patrick G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University of Virginia Division of Gastroenterology and Hepatology ]]></institution>
<addr-line><![CDATA[Charlottesville Virginia]]></addr-line>
<country>USA</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Virginia School of Medicine  ]]></institution>
<addr-line><![CDATA[Charlottesville Virginia]]></addr-line>
<country>USA</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2017</year>
</pub-date>
<volume>16</volume>
<numero>2</numero>
<fpage>279</fpage>
<lpage>284</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-26812017000200279&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-26812017000200279&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-26812017000200279&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction.  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.  In 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.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Ascites]]></kwd>
<kwd lng="en"><![CDATA[Cirrhosis]]></kwd>
<kwd lng="en"><![CDATA[Invasive Procedures]]></kwd>
<kwd lng="en"><![CDATA[Complications]]></kwd>
<kwd lng="en"><![CDATA[Peritonitis]]></kwd>
</kwd-group>
</article-meta>
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