A Study of Mucosal Sampling for Helicobacter pylori Using 'Two-bite' Technique in Relation to Time-saving.
- Author:
Mun Hee BAE
1
;
Min Hyung KIM
;
Jun Haeng LEE
;
Hee Jung SON
;
Yoon Ho CHOI
;
Poong Lyul RHEE
;
Jae J KIM
;
Seung Woon PAIK
;
Byung Cheol YOO
;
Jong Chul RHEE
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. leejh@smc.samsung.co.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Two-bite technique;
Endoscopy;
Forceps;
Biopsy
- MeSH:
Artifacts;
Biopsy;
Diagnosis;
Endoscopes;
Endoscopy;
Helicobacter pylori*;
Helicobacter*;
Humans;
Prospective Studies;
Surgical Instruments
- From:Korean Journal of Gastrointestinal Endoscopy
2004;29(1):1-5
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Multiple passages of biopsy forceps increase wear and tear on both the channel of endoscope and forceps. The two-bite technique can save time in obtaining sufficient specimens and also reduce the wear of the instruments. The aim of this study was to assess prospectively the efficacy of two-bite forceps technique in relation to time-saving. METHODS: A total 84 patients needed histopathologic diagnosis for Helicobacter pylori were randomized into two groups (one-bite technique: 41 patients, two-bite technique: 43 patients). An experienced endoscopist carried out upper endoscopy and used same biopsy forceps (FB-25K(R), Olympus, Tokyo, Japan). Mucosal biopsy specimens were obtained as follow: two from the antrum followed by two from the body. Rebiopsy was done when biopsy specimen was lost. The mean time in obtaining specimens and missing rate were analyzed. An experienced pathologist blinded to the technique of obtaining the samples evaluated the specimens for diameter, depth, crush artifact, and adequacy for histopathologic diagnosis. RESULTS: A total 336 specimens were obtained from 84 patients. Of these, 12 (7.0%) samples were missed with the two-bite technique but only 1 (0.6%) with the one-bite technique (p=0.003). Regarding histopathologic evaluation, there were no significant differences between samples taken with the two-bite technique and the one-bite technique. The mean time with two-bite technique (47.6 sec) was compared with one-bite technique (62.6 sec)(p<0.001). But there was no significant time difference if samples were missing during the process (62.5 sec). CONCLUSIONS: Although two- bite technique saves the time for biopsy, the main limitation is that there is a significant risk of losing samples.
