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Endoscopy 2016; 48(12): 1069-1075
DOI: 10.1055/s-0042-117274
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Comparison of different biopsy forceps models for tissue sampling in eosinophilic esophagitis

Christian Bussmann   *
1   Institute of Pathology, Viollier AG, Basel, Switzerland
,
Alain M. Schoepfer   *
2   Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
,
Ekaterina Safroneeva
3   Institute of Social and Preventive Medicine, University of Bern, Switzerland
,
Nadine Haas
3   Institute of Social and Preventive Medicine, University of Bern, Switzerland
,
Sébastien Godat
1   Institute of Pathology, Viollier AG, Basel, Switzerland
,
Christine Sempoux
4   Division of Pathology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
,
Hans-Uwe Simon
5   Institute of Pharmacology, University of Bern, Bern, Switzerland
,
Alex Straumann
6   Swiss EoE Clinic, Praxis Römerhof, Olten, Switzerland
› Author Affiliations
Further Information

Publication History

submitted 07 March 2016

accepted after revision 04 July 2016

Publication Date:
04 November 2016 (online)

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Background and aims: Eosinophilic esophagitis (EoE) is a mixed inflammatory and fibrostenotic disease. Unlike superficial inflammatory changes, subepithelial fibrosis is not routinely sampled in esophageal biopsies. This study aimed to evaluate the efficacy and safety of deep esophageal sampling with four different types of biopsy forceps.

Patients and methods: In this cross-sectional study, esophageal biopsies were taken in 30 adult patients by one expert endoscopist. Biopsies sampled from distal esophagus using a static jaw forceps (Olympus, FB-11K-1) were compared with proximal biopsies sampled with static jaw (Olympus, FB-45Q-1), alligator jaw (Olympus, FB-210K), and large-capacity forceps (Boston Scientific, Radial Jaw 4). One pathologist calculated the surface area of epithelial and subepithelial layers in hematoxylin and eosin (H&E)-stained biopsies.

Results: Subepithelial tissue was acquired in 97 % (static jaw FB-11K-1), 93 % (static jaw FB-45Q-1), 80 % (alligator jaw), and 55 % (large-capacity) of samples. Median (interquartile [IQR]) ratios of surface area of epithelial to subepithelial tissue were: static jaw FB-45Q-1, 1.07 (0.65 – 4.465); static jaw FB-11K-1, 1.184 (0.608 – 2.545); alligator jaw, 2.353 (1.312 – 4.465); and large-capacity, 2.71 (1.611 – 4.858). The static jaw models obtained a larger surface area of subepithelial tissue compared with the alligator jaw (P < 0.001 and P = 0.037, for FB-11K-1 and FB-45Q-1, respectively) and the large-capacity forceps (P < 0.001, for both static jaw models). No esophageal perforations occurred.

Conclusions: The static jaw forceps models allowed sampling of subepithelial tissue in > 90 % of biopsies and appear to be superior to alligator or large-capacity forceps in sampling larger amounts of subepithelial tissue.

* These authors contributed equally.


 

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