We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Surveillance colonoscopy in patients with inflammatory bowel disease: comparison of random biopsy vs. targeted biopsy protocols.
- Authors
Günther, Ute; Kusch, Dajana; Heller, Frank; Bürgel, Nataly; Leonhardt, Silke; Daum, Severin; Siegmund, Britta; Loddenkemper, Christoph; Grünbaum, Maria; Buhr, Heinz-Johannes; Schulzke, Jörg-Dieter; Zeitz, Martin; Bojarski, Christian
- Abstract
Background: Endoscopic surveillance in patients with long-standing inflammatory bowel disease (IBD) improves early detection of intraepithelial neoplasia (IEN). We aimed to compare three different endoscopic surveillance strategies in the detection of IEN. Methods: One hundred fifty surveillance colonoscopies (ulcerative colitis, UC n = 141; Crohn's disease, CD n = 9) were carried out. Random quadrant biopsies were taken (group I, n = 50). Chromoendoscopy with indigo carmine was performed and subsequently quadrant biopsies were collected (group II, n = 50). Patients in group III ( n = 50) underwent confocal endomicroscopy (CEM), and CEM-guided as well as random quadrant biopsies were taken (group III, n = 50). The findings of CEM were correlated to conventional histology. Patients with high-grade IEN underwent surgery or strict follow-up by patients' request. Results: In group I (1531 biopsies), no IEN was detected by histology. In group II (1,811 biopsies), chromoendoscopy-guided biopsies revealed high-grade IEN in two patients (4% detection rate). In four patients of group III (1477 biopsies), areas with high-grade IEN were clearly visible by CEM and confirmed by histology (8% detection rate, p < 0.05). Of six patients with high-grade IEN, five patients underwent proctocolectomy. Colorectal cancer was detected in one out of five patients. Conclusion: Targeted biopsy protocols guided by either chromoendoscopy or CEM led to higher detection rates of IEN and are thus mandatory for surveillance colonoscopies in patients with long-standing UC. Random biopsy protocols should be replaced by chromoendoscopy-guided protocols.
- Subjects
COLONOSCOPY; INFLAMMATORY bowel diseases; BIOPSY; HISTOLOGY; COLON cancer diagnosis; PATIENTS
- Publication
International Journal of Colorectal Disease, 2011, Vol 26, Issue 5, p667
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-011-1130-y