Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres Across Europe.


Journal

Digestive diseases (Basel, Switzerland)
ISSN: 1421-9875
Titre abrégé: Dig Dis
Pays: Switzerland
ID NLM: 8701186

Informations de publication

Date de publication:
2021
Historique:
received: 06 08 2020
accepted: 26 09 2020
pubmed: 2 10 2020
medline: 22 5 2021
entrez: 1 10 2020
Statut: ppublish

Résumé

Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.

Sections du résumé

BACKGROUND
Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe.
METHODS
Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored.
RESULTS
Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022).
CONCLUSION
Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.

Identifiants

pubmed: 33002891
pii: 000511867
doi: 10.1159/000511867
pmc: PMC8220928
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

179-189

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2020 The Author(s) Published by S. Karger AG, Basel.

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Auteurs

Terry Tran-Nguyen (T)

Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals, Headington, Oxford, United Kingdom.
NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom.

Gloria Fernandez-Esparrach (G)

Gastroenterology Department, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.

Stephen Ash (S)

Nuffield Department of Medicine, Ludwig Institute for Cancer Research, University of Oxford, Oxford, United Kingdom.

Francesc Balaguer (F)

Gastroenterology Department, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.

Elizabeth L Bird-Lieberman (EL)

Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals, Headington, Oxford, United Kingdom.
NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom.

Henry Córdova (H)

Gastroenterology Department, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.

Zane Dzerve (Z)

Digestive Diseases Centre GASTRO, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.

Matteo Fassan (M)

Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy.

Marcis Leja (M)

Digestive Diseases Centre GASTRO, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.

Ivan Lyutakov (I)

Department of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria.

Tim Middelburg (T)

Department of Gastroenterology & Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Leticia Moreira (L)

Gastroenterology Department, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.

Radislav Nakov (R)

Department of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria.

Stella A V Nieuwenburg (SAV)

Department of Gastroenterology & Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Anthony O'Connor (A)

Department of Gastroenterology, Tallaght University Hospital, University of Dublin, Trinity College, Dublin, Ireland.

Stefano Realdon (S)

Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

Heiko De Schepper (H)

Department of Gastroenterology & Hepatology, University Hospital Antwerp, Edegem, Belgium.

Annemieke Smet (A)

Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.

M C W Spaander (MCW)

Department of Gastroenterology & Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Ivars Tolmanis (I)

Digestive Diseases Centre GASTRO, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.

Tadas Urbonas (T)

Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Jochen Weigt (J)

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany.

Georgina L Hold (GL)

Microbiome Research Centre, St George & Sutherland Clinical School, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia.

Alexander Link (A)

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany.

Juozas Kupcinskas (J)

Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals, Headington, Oxford, United Kingdom, jan.bornschein@ouh.nhs.uk.
NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom, jan.bornschein@ouh.nhs.uk.
Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany, jan.bornschein@ouh.nhs.uk.
Gastroenterology Department, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain, jan.bornschein@ouh.nhs.uk.
Nuffield Department of Medicine, Ludwig Institute for Cancer Research, University of Oxford, Oxford, United Kingdom, jan.bornschein@ouh.nhs.uk.
Digestive Diseases Centre GASTRO, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia, jan.bornschein@ouh.nhs.uk.
Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy, jan.bornschein@ouh.nhs.uk.
Department of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria, jan.bornschein@ouh.nhs.uk.
Department of Gastroenterology & Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands, jan.bornschein@ouh.nhs.uk.
Department of Gastroenterology, Tallaght University Hospital, University of Dublin, Trinity College, Dublin, Ireland, jan.bornschein@ouh.nhs.uk.
Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy, jan.bornschein@ouh.nhs.uk.
Department of Gastroenterology & Hepatology, University Hospital Antwerp, Edegem, Belgium, jan.bornschein@ouh.nhs.uk.
Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium, jan.bornschein@ouh.nhs.uk.
Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania, jan.bornschein@ouh.nhs.uk.
Microbiome Research Centre, St George & Sutherland Clinical School, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia, jan.bornschein@ouh.nhs.uk.

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