Which type of biopsies are performed in the surveillance of Barrett's oesophagus?

In the surveillance of Barrett's oesophagus, quadrantic biopsies are implemented to detect dysplasia and early neoplastic changes effectively. This method involves taking biopsies at four-quadrant intervals from the esophagus at defined distances, often every 1 to 2 cm, which allows for a systematic assessment of the mucosal surface.

The rationale behind using quadrantic biopsies is that Barrett's oesophagus can exhibit patchy dysplastic changes, and random sampling may miss areas of concern. By using a standardized approach of sampling from all four quadrants, the likelihood of detecting dysplastic lesions is greatly enhanced, thereby improving the surveillance outcomes for patients at risk of esophageal adenocarcinoma.

Other types of biopsies, such as core needle biopsies and endoscopic mucosal resection, have different indications and are not routinely used for the surveillance of Barrett's oesophagus. Core needle biopsies are generally utilized for solid lesions and are not suitable in this context, whereas endoscopic mucosal resection is more appropriate for specific therapeutic interventions rather than routine surveillance. Random biopsies lack the systematic approach needed to comprehensively evaluate the condition effectively, which is why quadrantic biopsies are preferred in clinical practice for monitoring Barrett's oesophagus.