Use of a new jumbo forceps improves tissue acquisition of Barrett's esophagus surveillance biopsies.
BACKGROUND
The major risk factors for the development of esophageal adenocarcinoma remain long-standing GERD and resultant Barrett's esophagus (BE). Finding the exact method of adequate tissue sampling for surveillance of dysplasia in BE remains a dilemma.


OBJECTIVE
We prospectively compared standard large-capacity biopsy forceps with a new jumbo biopsy forceps for dysplasia detection in BE.


METHODS
Prospective, single-center investigation.


METHODS
We prospectively enrolled 32 patients undergoing surveillance endoscopy for BE. Biopsy samples were obtained in paired fashion alternating between the experimental (jumbo) and control (large-capacity) forceps.


METHODS
Each sample was assessed for histopathology, specimen size, and adequacy.


RESULTS
A total of 712 specimens were available for analysis for this investigation. Six patients were found to have dysplasia, and in 5 of those patients, the dysplasia was only detected with the jumbo forceps. The mean width was significantly greater in the Radial Jaw 4 jumbo group (3.3 mm vs 1.9 mm [P < .005]) as was the mean depth (2.0 mm vs 1.1 mm [P < .005]). Sixteen percent of samples obtained with the standard forceps provided an adequate sample, whereas the jumbo forceps provided an adequate sample 79% of the time (P < .05).


CONCLUSIONS
A lack of a validated index for assessment of tissue adequacy in BE.


CONCLUSIONS
The Radial Jaw 4 jumbo biopsy forceps significantly improves dysplasia detection and adequate tissue sampling in patients undergoing endoscopy for BE.
Komanduri
Sri
S
Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. sri_komanduri@yahoo.com
Swanson
Garth
G
Keefer
Laurie
L
Jakate
Shriram
S
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000473:pathology*; D001706:Biopsy / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000473:pathology; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments