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Veterinary surgery : VS2024; doi: 10.1111/vsu.14178

Ex vivo comparison of full-thickness biopsy techniques in the equine small intestine.

Abstract: To compare the practicability and tissue sample quality between different intestinal biopsy techniques. Methods: Experimental, randomized ex vivo study. Methods: Small intestine of nine horses. Methods: Four different biopsy techniques were evaluated in the aboral jejunum and the ileum within 1 h after euthanasia. One segment was used as control (C), and the applied techniques included an 8 mm biopsy punch (BP), transverse wedge resection (TW), longitudinal wedge resection with transverse closure (LW) and a longitudinal sample using Eppendorfer biopsy forceps (EF). Defects were closed using a single-layer continuous Lembert pattern. Duration of the procedure, intestinal diameter, contamination, and bursting pressure were determined. The quality of the obtained tissue samples for histological assessment was evaluated using a semiquantitative score. The jejunal and ileal samples were analyzed separately. Results: All biopsy procedures including defect closure were completed within 5 min, with shorter closure times for BP (p = .03). Minimal contamination could be noted in 1/8 TW and 2/8 LW cases, without significant differences between the groups. Longitudinal closure techniques (BP, EF) showed more constriction than transverse closures (TW, LW) (p 75 mmHg in all cases. Technique BP showed significantly lower biopsy quality scores (p = .009). Conclusions: The tested biopsy techniques could all be applied effectively within a reasonable time frame, yet the biopsy punch was associated with significant artifacts and risk of missing mucosa. Conclusions: The findings provide insights into the possible advantages and limitations of the different techniques and alert the surgeon to potential issues with the quality of the tissue sample.
© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2024-10-15 PubMed ID: 39404177DOI: 10.1111/vsu.14178Google Scholar: Lookup
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Summary

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The research paper focuses on comparing various biopsy techniques, specifically in relation to their practicability and the quality of the tissue samples they procure in the small intestine of horses. The study finds some differences between the techniques but indicates that all can be effectively applied within a reasonable time frame. However, the biopsy punch is recognized as potentially causing significant artifacts and risk in missing mucosa.

Introduction and Methodology

  • The study is experimental in nature, randomly applying different biopsy techniques to the small intestine of nine horses post-euthanasia.
  • Four biopsy techniques were employed on segments of the aboral jejunum and ileum. These techniques include an 8mm biopsy punch (BP), transverse wedge resection (TW), longitudinal wedge resection with transverse closure (LW), and a longitudinal sample using Eppendorfer biopsy forceps (EF). An untouched segment was used as control (C).
  • The defects created by these procedures were then closed using a common surgical stitching pattern, called the Lembert pattern.
  • Several factors were considered in scrutinizing the procedures: the duration of the procedure, the diameter of the intestine, the level of contamination, the bursting pressure, and finally the quality of the tissue samples procured as evaluated through a semiquantitative score.

Results and Analysis

  • All biopsy techniques (including defect closure) were successfully completed within 5 minutes, with the biopsy punch method having significantly shorter closure times.
  • Minimal contamination was observed only in TW and LW cases, but the differences between techniques were not significant.
  • The BP and EF techniques, which employ longitudinal closure, showed more constriction than the TW and LW techniques, which use transverse closures.
  • All techniques managed to maintain a bursting pressure greater than 75 mmHg.
  • However, the biopsy punch technique showed a significantly lower biopsy quality score, meaning it produced inferior tissue samples compared to other techniques.

Conclusions

  • All the tested biopsy techniques proved practicable and could be executed within a reasonable timeframe.
  • Notwithstanding, the biopsy punch technique was highlighted as having potential issues. It was found to be associated with creating significant artifacts and presented a higher risk of missing mucosa.
  • Therefore, while all techniques can be effectively applied, caveats, such as potential quality issues with biopsy punch, need to be kept in mind. This can guide veterinarians and surgeons in choosing the most suitable technique for specific applications, improving the overall quality of equine intestinal care.

Cite This Article

APA
Verhaar N, Hammer E, Reineking W, Hewicker-Trautwein M, Geburek F. (2024). Ex vivo comparison of full-thickness biopsy techniques in the equine small intestine. Vet Surg. https://doi.org/10.1111/vsu.14178

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Verhaar, Nicole
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Hammer, Elisabeth
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Reineking, Wencke
  • Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany.
Hewicker-Trautwein, Marion
  • Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany.
Geburek, Florian
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.

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