Original articleClinical endoscopyIncremental diagnostic yield of chromoendoscopy and outcomes in inflammatory bowel disease patients with a history of colorectal dysplasia on white-light endoscopy
Section snippets
Methods
The study was approved by the Mayo Clinic Institutional Review Board (PR13-005765-01), and only the medical records of patients who authorized retrospective review of their medical records for research purposes were included in the study. Medical records were abstracted from consecutive IBD patients with colorectal dysplasia detected with WLE (index) colonoscopy who underwent CE at our institution between January 1, 2006 and August 31, 2013. Included in the analysis were patients 18 years of
Results
Ninety-five index cases were identified with a median age of 58.0 years (interquartile range 46-66 years) and a median IBD duration of 18 years (interquartile range 9.3-29.8 years) (Table 1). There was a male predominance (n = 65, 68.4%); most cases were identified among patients with a history of UC (n = 78, 82.1%) and pancolonic disease extent (n = 74, 77.9%). A history of PSC was reported in 23 patients (24.2%), and a family history of CRC was noted in 21 (22.3%). Additionally, current
Discussion
This study demonstrated that performing CE in IBD patients with a history of colorectal dysplasia on WLE identified new lesions likely missed on initial WLE examination, which were often amenable to endoscopic resection. Furthermore, continued surveillance with CE identified additional lesions amenable to endoscopic resection. The miss rate for colorectal dysplasia was lower with CE than with WLE in this high-risk population.
A meta-analysis of clinical studies supports the use of CE with
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Cited by (27)
Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease
2019, Gastrointestinal EndoscopyCitation Excerpt :CE has been shown to be superior to previous surveillance methods in a number of outcome categories. First, this technique generates an increased diagnostic yield for dysplasia compared with standard white-light endoscopy, both de novo and in patients with a history or previously identified premalignant lesions.9-11 Second, the use of CE is a more cost-effective method of surveillance.12
Dysplasia Surveillance in Inflammatory Bowel Disease
2019, Clinical Gastrointestinal EndoscopyAssessment of peri-polyp biopsy specimens of flat mucosa in patients with inflammatory bowel disease
2018, Gastrointestinal EndoscopyCitation Excerpt :Such intervals for follow-up have not been defined in any prospective study, so including these risk factors can aid clinicians and patients in decision-making. The role for subsequent chromoendoscopy in higher risk patients has been studied, and the limited data do suggest an additional yield in performing dye spray colonoscopy in patients with prior dysplastic polypoid and nonpolypoid lesions.33,34 There is still a role for performing additional biopsy samples after polypectomy in patients with chronic colitis.
Endoscopy in inflammatory bowel disease: advances in dysplasia detection and management
2017, Gastrointestinal EndoscopyCitation Excerpt :The recommendations were based on a meta-analysis of 8 studies from 5 different countries and include various study designs (2 randomized and 4 tandem studies comparing standard white-light endoscopy and chromoendoscopy and a tandem study evaluating high-definition white light). Several studies have subsequently been published, most of which were retrospective, and overall support the shift to continue toward targeted biopsy sampling for dysplasia detection.10,33-37 Marion et al36 highlighted the quality of a chromoendoscopy examination in a prospective longitudinal study.
Response:
2016, Gastrointestinal Endoscopy
DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
If you would like to chat with an author of this article, you may contact Dr Deepak at [email protected].
See CME section; p. 1023.