title: Biopsy specimens obtained with small-caliber endoscopes have comparable diagnostic performances than those obtained with conventional endoscopes: a prospective study on 1335 specimens.
abstract: OBJECTIVE
  Esophagogastroduodenoscopy (EGD) can be routinely performed via a nasal route in adults by using small-caliber endoscopes. The aim of this study was to evaluate the adequacy of biopsy specimens obtained with small forceps for histologic diagnosis.
  
  
  METHODS
  From January to April 2007, we prospectively compared all biopsy specimens obtained, during conventional EGD (8.8-mm-diameter endoscope), with (CS-EGD) or without sedation (C-EGD), and transnasal or transoral-EGD (4.9-mm-diameter endoscope) without sedation (T-EGD). All biopsy specimens were blindly evaluated by a pathologist. For each specimen, were recorded: site, biopsy size and thickness, type of lesion (focal or diffuse), and in case of focal abnormalities described by the endoscopist, presence of the histologic lesions in the targeted biopsies.
  
  
  RESULTS
  One thousand and thirty-five biopsy specimens were obtained from 300 procedures (109 T-EGD, 48 C-EGD, and 143 CS-EGD): 983 biopsy specimens were untargeted (esophagus and cardia in 21%, stomach in 85% and duodenum in 84%) and 352 biopsy specimens were targeted to focal lesions (esophagus and cardia in 79%, stomach in 15%, and duodenum in 16%). The mean size of specimens was 1.8, 2, 2.2 mm diameter, in T-EGD, C-EGD, and CS-EGD groups, respectively (P<0.001). The whole thickness of mucosa was present in 68%, 84%, 71% of the cases among T-EGD, C-EGD, and CS-EGD groups, respectively (P=0.9). There was no significant difference in the rate of definitive histologic diagnosis from targeted or nontargeted biopsies according to the endoscopic procedure.
  
  
  CONCLUSIONS
  Biopsy specimens obtained during EGD with small forceps are as effective for diagnosis as those obtained with standard forceps.
authors: Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, Villeurbanne, France.
authors: Thomas
authors: T
authors: Walter
authors: Anne-Laure
authors: AL
authors: Chesnay
authors: Jérôme
authors: J
authors: Dumortier
authors: Florence
authors: F
authors: Mège-LeChevallier
authors: Valérie
authors: V
authors: Hervieu
authors: Olivier
authors: O
authors: Guillaud
authors: Marie-George
authors: MG
authors: Lapalus
authors: Vincent
authors: V
authors: Lépilliez
authors: Fabien
authors: F
authors: Fumex
authors: Thierry
authors: T
authors: Ponchon
authors: Jean-Yves
authors: JY
authors: Scoazec
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation; D020776:Endoscopes, Gastrointestinal; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D013525:Surgical Instruments; D055815:Young Adult