Literature DB >> 16283340

Reduction of miss rates of colonic adenomas by zoom chromoendoscopy.

N Stergiou1, M B Frenz, D Menke, A Riphaus, T Wehrmann.   

Abstract

BACKGROUND AND AIMS: The aim of this study was to determine the detection rate of polyps using zoom chromoendoscopy (ZE) compared with standard video colonoscopy. PATIENTS AND METHODS: End-to-end colonoscopies were performed in 50 patients by two different endoscopists blinded for each other's results. Lesions detected during initial standard colonoscopy (C1) were biopsied or removed by snare resection. The second colonoscopy (C2) was done with a zoom colonoscope spraying the whole colon with indigocarmine (0.4%). In addition, detected mucosal lesions were documented prior to ZE and then classified according to the pit pattern classification before biopsy or removal. The retrieval time for each procedure was determined.
RESULTS: The average retrieval time for C1 was 13+/-9 min (9-24) and 28+/-11 min (16-38, p<0.05) for ZE. During C1, 56 lesions were detected in 26 of 50 patients (34 hyperplastic and 22 adenomatous). During C2, 19 additional polyps were documented prior to ZE (15% tandem miss rate), and 20 further lesions were detected with ZE (21% additional polyp detection rate compared to C1 and C2 without ZE). Of the 39 additional lesions removed during C2 after ZE, 29 were hyperplastic and 10 were adenomatous. Most adenomas detected during the second investigation were found in patients in whom adenomatous polyps had already been removed during the initial colonoscopy (9 of 26 patients vs 1 of 24 patients, p<0.02). No carcinoma was detected. The pit pattern classification allowed a correct differentiation between hyperplastic and adenomatous polyps (accuracy 93%, sensitivity 90%, specificity 97%).
CONCLUSION: Using zoom chromoendoscopy, the rate of detecting colonic polyps can be increased at the cost of a longer retrieval time.

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Year:  2005        PMID: 16283340     DOI: 10.1007/s00384-005-0052-y

Source DB:  PubMed          Journal:  Int J Colorectal Dis        ISSN: 0179-1958            Impact factor:   2.571


  24 in total

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Review 2.  Endoscopic appearance of dysplasia in ulcerative colitis and the role of staining.

Authors:  M Rutter; C Bernstein; T Matsumoto; R Kiesslich; M Neurath
Journal:  Endoscopy       Date:  2004-12       Impact factor: 10.093

3.  Chromoendoscopy with indigocarmine improves the detection of adenomatous and nonadenomatous lesions in the colon.

Authors:  R Kiesslich; M von Bergh; M Hahn; G Hermann; M Jung
Journal:  Endoscopy       Date:  2001-12       Impact factor: 10.093

4.  Assessment of colorectal lesions using magnifying colonoscopy and mucosal dye spraying: can significant lesions be distinguished?

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Journal:  Endoscopy       Date:  2001-04       Impact factor: 10.093

5.  Colorectal tumours and pit pattern.

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Journal:  J Clin Pathol       Date:  1994-10       Impact factor: 3.411

6.  Impact of bowel preparation on efficiency and cost of colonoscopy.

Authors:  Douglas K Rex; Thomas F Imperiale; Danielle R Latinovich; L Lisa Bratcher
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7.  Flat adenomas in the United Kingdom: are treatable cancers being missed?

Authors:  T Fujii; B J Rembacken; M F Dixon; S Yoshida; A T Axon
Journal:  Endoscopy       Date:  1998-06       Impact factor: 10.093

8.  Clinical accuracy in the diagnosis of small polyps using the flexible fiberoptic sigmoidoscope.

Authors:  P H Chapuis; O F Dent; K J Goulston
Journal:  Dis Colon Rectum       Date:  1982-10       Impact factor: 4.585

9.  Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup.

Authors:  S J Winawer; A G Zauber; M N Ho; M J O'Brien; L S Gottlieb; S S Sternberg; J D Waye; M Schapiro; J H Bond; J F Panish
Journal:  N Engl J Med       Date:  1993-12-30       Impact factor: 91.245

10.  Total colonic dye-spray increases the detection of diminutive adenomas during routine colonoscopy: a randomized controlled trial.

Authors:  Jim C Brooker; Brian P Saunders; Syed G Shah; Catherine J Thapar; Huw J W Thomas; Wendy S Atkin; Christopher R Cardwell; Christopher B Williams
Journal:  Gastrointest Endosc       Date:  2002-09       Impact factor: 9.427

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  1 in total

Review 1.  Colonoscopic polypectomy: a critical review of recent literature.

Authors:  Peter H Rubin; Jerome D Waye
Journal:  Curr Gastroenterol Rep       Date:  2006-10
  1 in total

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