Duan ZH, Zhou SY. Biopsy forceps are useful for measuring esophageal varices in vitro. World J Gastrointest Surg 2024; 16(2): 539-545 [PMID: 38463364 DOI: 10.4240/wjgs.v16.i2.539]
Corresponding Author of This Article
Zhi-Hui Duan, MM, Attending Doctor, Endoscopy Center, Xingtai People’s Hospital of Hebei Medical University, No. 16 Hongxing Street, Xingtai 054000, Hebei Province, China. 15131988129@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2024; 16(2): 539-545 Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.539
Biopsy forceps are useful for measuring esophageal varices in vitro
Zhi-Hui Duan, Sheng-Yun Zhou
Zhi-Hui Duan, Sheng-Yun Zhou, Endoscopy Center, Xingtai People’s Hospital, Xingtai 054000, Hebei Province, China
Author contributions: Duan ZH contributed to the concept and design of this study, acquisition, analysis, interpretation of data, statistical analysis and drafting of the manuscript; Duan ZH and Zhou SY were involved in the critical revision of the manuscript for important intellectual content.
Institutional review board statement: This study was approved by the ethics committee of Xingtai People’s Hospital on June 28,2023 (approval No. 2023046), and in accordance with the Helsinki Declaration of 1975.
Informed consent statement: All study participants provided informed consent prior to this online survey.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original data can be obtained from the correspondence author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Hui Duan, MM, Attending Doctor, Endoscopy Center, Xingtai People’s Hospital of Hebei Medical University, No. 16 Hongxing Street, Xingtai 054000, Hebei Province, China. 15131988129@163.com
Received: October 15, 2023 Peer-review started: October 15, 2023 First decision: December 6, 2023 Revised: December 20, 2023 Accepted: January 9, 2024 Article in press: January 9, 2024 Published online: February 27, 2024 Processing time: 133 Days and 2.1 Hours
Abstract
BACKGROUND
To avoid acute variceal bleeding in cirrhosis, current guidelines recommend screening for high-risk esophageal varices (EVs) by determining variceal size and identifying red wale markings. However, visual measurements of EV during routine endoscopy are often inaccurate.
AIM
To determine whether biopsy forceps (BF) could be used as a reference to improve the accuracy of binary classification of variceal size.
METHODS
An in vitro self-made EV model with sizes ranging from 2 to 12 mm in diameter was constructed. An online image-based survey comprising 11 endoscopic images of simulated EV without BF and 11 endoscopic images of EV with BF was assembled and sent to 84 endoscopists. The endoscopists were blinded to the actual EV size and evaluated the 22 images in random order.
RESULTS
The respondents included 48 academic and four private endoscopists. The accuracy of EV size estimation was low in both the visual (13.81%) and BF-based (20.28%) groups. The use of open forceps improved the ability of the endoscopists to correctly classify the varices by size (small ≤ 5 mm, large > 5 mm) from 71.85% to 82.17% (P < 0.001).
CONCLUSION
BF may improve the accuracy of EV size assessment, and its use in clinical practice should be investigated.
Core tip: This study explored whether biopsy forceps (BF) could be used as a reference to improve the accuracy of binary classification of variceal size. Our results showed that visual estimation was insufficient for accurate classification of esophageal varices according to size, and the ability of endoscopists to correctly classify the varices by size improved significantly with the use of BF.
