Ex vivo comparison of full-thickness biopsy techniques in the equine small intestine.
Authors: Verhaar Nicole, Hammer Elisabeth, Reineking Wencke, Hewicker-Trautwein Marion, Geburek Florian
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Equine Small Intestinal Biopsy Techniques Obtaining high-quality intestinal tissue samples remains essential for diagnosing conditions such as inflammatory bowel disease and malabsorption in horses, yet the optimal biopsy method remains unclear. Researchers compared four techniques—an 8 mm biopsy punch, transverse wedge resection, longitudinal wedge resection with transverse closure, and Eppendorfer forceps sampling—using small intestine tissue from nine horses within one hour of euthanasia, evaluating procedural efficiency, tissue quality, contamination risk, and wound integrity through bursting pressure testing. All methods completed sampling and closure in under 5 minutes, with the punch technique being fastest; however, longitudinal closure approaches (punch and forceps) produced more intestinal constriction than transverse closures, and crucially, the punch technique yielded significantly lower histological sample quality with greater risk of mucosal damage and missing pathological changes. Despite all techniques maintaining adequate wound bursting pressure (>75 mmHg) to withstand normal intestinal motility, these findings suggest that transverse or longitudinal wedge resection methods may offer superior tissue quality for diagnostic purposes, whilst the punch biopsy—though quicker to close—carries material risk of sampling artifact that could compromise diagnosis in challenging cases. Practitioners should weigh speed against diagnostic reliability when selecting an intestinal biopsy approach, particularly when inflammatory lesions are patchy or subtle, ensuring the tissue obtained will adequately reflect the patient's pathology.
Read the full abstract on PubMed
Practical Takeaways
- •Avoid biopsy punch technique for equine intestinal biopsies due to poor tissue quality and high risk of missing diagnostic mucosa; prefer wedge resection or Eppendorfer forceps instead
- •Transverse wedge resection offers better functional outcomes with less post-closure constriction compared to longitudinal techniques, which may be relevant for post-operative intestinal diameter preservation
- •All tested techniques can be safely completed within 5 minutes with adequate closure strength (>75 mmHg bursting pressure), supporting their feasibility in clinical practice
Key Findings
- •All four biopsy techniques (punch, transverse wedge, longitudinal wedge, Eppendorfer forceps) completed within 5 minutes including closure, with punch technique showing fastest closure time (p=0.03)
- •Biopsy punch technique produced significantly lower tissue quality scores (p=0.009) with increased risk of artifacts and missing mucosa compared to other methods
- •Longitudinal closure techniques showed more intestinal constriction than transverse closures (p<0.05), though all techniques achieved bursting pressures >75 mmHg
- •Minimal contamination observed across techniques (1/8 transverse wedge, 2/8 longitudinal wedge cases) with no significant differences between groups