Surveillance colonoscopy in patients with inflammatory bowel disease: comparison of random biopsy vs. targeted biopsy protocols View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-05

AUTHORS

Ute Günther, Dajana Kusch, Frank Heller, Nataly Bürgel, Silke Leonhardt, Severin Daum, Britta Siegmund, Christoph Loddenkemper, Maria Grünbaum, Heinz-Johannes Buhr, Jörg-Dieter Schulzke, Martin Zeitz, Christian Bojarski

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. More... »

PAGES

667-672

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00384-011-1130-y

DOI

http://dx.doi.org/10.1007/s00384-011-1130-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1021662757

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21279369


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