title: Improved specimen adequacy using jumbo biopsy forceps in patients with Barrett's esophagus.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Martinek
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Maluskova
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Stefanova
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Inna
authors.initials: I
authors.lastname: Tuckova
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Stepan
authors.initials: S
authors.lastname: Suchanek
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Vackova
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Krajciova
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Kollar
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Zavoral
authors.affiliation: Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.
authors.forename: Julius
authors.initials: J
authors.lastname: Spicak
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D001706:Biopsy / Q000295:instrumentation*; D018153:Czech Republic; D004867:Equipment Design; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016037:Single-Blind Method; D013525:Surgical Instruments
keywords: Barrett’s esophagus; Barrett’s esophagus-related neoplasia; Biopsy forceps; Jumbo forceps; Specimen adequacy