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  • Wide-area transepithelial sampling in adjunct to forceps biopsy increases the absolute detection rates of Barrett’s oesophagus and oesophageal dysplasia: a meta-analysis and systematic review

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Barrett’s oesophagus
Wide-area transepithelial sampling in adjunct to forceps biopsy increases the absolute detection rates of Barrett’s oesophagus and oesophageal dysplasia: a meta-analysis and systematic review
  1. Vishnu Charan Suresh Kumar1,
  2. Prateek Harne1,
  3. Venkata Suresh Patthipati2,
  4. Abinash Subedi1,
  5. Umair Masood3,
  6. Anuj Sharma3,
  7. Faith Goyal4,
  8. Nancy Aggarwal5,
  9. Bishnu Sapkota3,6
  1. 1Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
  2. 2Department of Internal Medicine, Trumbull Regional Medical Center, Warren, Ohio, USA
  3. 3Division of Gastroenterology, SUNY Upstate Medical University, Syracuse, New York, USA
  4. 4Department of Electronics and Communication Engineering, Maharaja Agrasen Institute of Technology, Delhi, India
  5. 5Department of Physics, Northwestern University, Evanston, Illinois, USA
  6. 6Division of Gastroenterology, Syracuse VA Medical Center, Syracuse, New York, USA
  1. Correspondence to Dr Vishnu Charan Suresh Kumar; drvishnucharan{at}gmail.com

Abstract

Background Wide-area transepithelial sampling (WATS) is a new technique that uses an abrasive brush to obtain samples from a larger surface area of the oesophagus. Studies have shown promising results that WATS in adjunct to forceps biopsy (FB) increases the detection rate of Barrett’s oesophagus (BE) as well as oesophageal dysplasia (ED). We conducted a systematic review and meta-analysis to compare the detection rates of BE and ED between FB and WATS in adjunct to FB.

Methods A Literature search was done using electronic databases, including PubMed, Embase, Scopus, Cochrane and CINAHL from inception to 26 April 2020. A meta-analysis comparing detection rates of WATS in adjunct to FB versus FB using the random-effects model was done using RevMan V.5.3.

Results Pooled data from 20 392 endoscopies across 11 studies showed an absolute increase in detection of 16% (95% CI 0.10% to 0.22%, p<0.00001). A relative increase of 1.62 was seen in detection rates of BE (95% CI 1.28 to 2.05, p<0.0001) when WATS was used with FB with the number needed to test (NNT) of 6.1 patients. For ED, a 2% absolute increase (95% CI 0.01 to 0.03, p=0.001) in additional diagnostic yield from WATS. A relative increase of 2.05 was seen in the detection rate of ED (95% CI 1.42 to 2.98, p=0.0001) yielding an NNT of 50 patients.

Conclusion Our study shows that WATS, as an adjunct to FB, improves both the absolute detection rate and relative detection rate of both BE and ED as compared to FB alone.

  • Barrett's oesophagus
  • Barrett's metaplasia
  • Endoscopic procedures
  • Oesophageal lesions
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjgast-2020-000494

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    Footnotes

    • Contributors VCSK (Conceptualisation: Lead; Data curation: Lead; Methodology: Equal; Project administration: Equal; Resources: Lead; Writing—original draft: Lead; Writing—review and editing: Lead). PH (Resources: Equal; Writing—original draft: Lead; Writing—review and editing: Lead). VSP (Formal analysis: Lead; Validation: Lead; Writing—original draft: Equal; Writing—review and editing: Equal). AS (Data curation: Lead; Methodology: Equal; Resources: Equal). UM (Conceptualisation: Supporting; Resources: Supporting; Writing—review and editing: Supporting). AS (Resources: Supporting; Supervision: Supporting; Writing—review and editing: Supporting). FG (Formal analysis: Support, Validation: support). NA (Formal analysis: Support, Validation: support). BS (Conceptualisation: Equal; Methodology: Equal; Project administration: Lead; Resources: Lead; Supervision: Lead; Validation: Equal; Writing—original draft: Supporting; Writing—review and editing: Equal).

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as online supplemental information.