Published online May 7, 2015. doi: 10.3748/wjg.v21.i17.5328
Peer-review started: November 17, 2014
First decision: December 11, 2014
Revised: January 21, 2015
Accepted: February 11, 2015
Article in press: February 11, 2015
Published online: May 7, 2015
Processing time: 177 Days and 9.2 Hours
AIM: To assess the sampling quality of four different forceps (three large capacity and one jumbo) in patients with Barrett’s esophagus.
METHODS: This was a prospective, single-blind study. A total of 37 patients with Barrett’s esophagus were enrolled. Targeted or random biopsies with all four forceps were obtained from each patient using a diagnostic endoscope during a single endoscopy. The following forceps were tested: A: FB-220K disposable large capacity; B: BI01-D3-23 reusable large capacity; C: GBF-02-23-180 disposable large capacity; and jumbo: disposable Radial Jaw 4 jumbo. The primary outcome measurement was specimen adequacy, defined as a well-oriented biopsy sample 2 mm or greater with the presence of muscularis mucosa.
RESULTS: A total of 436 biopsy samples were analyzed. We found a significantly higher proportion of adequate biopsy samples with jumbo forceps (71%) (P < 0.001 vs forceps A: 26%, forceps B: 17%, and forceps C: 18%). Biopsies with jumbo forceps had the largest diameter (median 2.4 mm) (P < 0.001 vs forceps A: 2 mm, forceps B: 1.6 mm, and forceps C: 2mm). There was a trend for higher diagnostic yield per biopsy with jumbo forceps (forceps A: 0.20, forceps B: 0.22, forceps C: 0.27, and jumbo: 0.28). No complications related to specimen sampling were observed with any of the four tested forceps.
CONCLUSION: Jumbo biopsy forceps, when used with a diagnostic endoscope, provide more adequate specimens as compared to large-capacity forceps in patients with Barrett’s esophagus.
Core tip: Good quality biopsy specimens are required for reliable diagnosis of early neoplasia in patients with Barrett’s esophagus. It remains controversial whether the use of jumbo forceps provides an advantage over large-capacity forceps. We compared the sampling quality using four different biopsy forceps. Biopsies were obtained using a diagnostic endoscope during a single endoscopy. We found a significantly higher proportion of adequate biopsy samples with jumbo forceps as compared to the three large capacity forceps. Thus, jumbo biopsy forceps, when used with a diagnostic endoscope, provide more adequate specimen as compared to large-capacity forceps.