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High-Definition Chromoendoscopy Versus High-Definition White Light Colonoscopy for Neoplasia Surveillance in Ulcerative Colitis: A Randomized Controlled Trial
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High-Definition Chromoendoscopy Versus High-Definition White Light Colonoscopy for Neoplasia Surveillance in Ulcerative Colitis: A Randomized Controlled Trial
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High-Definition Chromoendoscopy Versus High-Definition White Light Colonoscopy for Neoplasia Surveillance in Ulcerative Colitis: A Randomized Controlled Trial
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Journal Article
High-Definition Chromoendoscopy Versus High-Definition White Light Colonoscopy for Neoplasia Surveillance in Ulcerative Colitis: A Randomized Controlled Trial
2019
Overview
Although chromoendoscopy is currently the recommended mode of surveillance in patients with long-standing ulcerative colitis, it is technically challenging and requires a long procedure time. The aim of this study was to compare the dysplasia detection rate of high-definition white light endoscopy with random biopsy (HDWL-R) vs high-definition chromoendoscopy with targeted biopsy (HDCE-T).
This was a multicenter, prospective randomized controlled trial involving 9 tertiary teaching hospitals in South Korea. A total of 210 patients with long-standing ulcerative colitis were randomized to undergo either the HDWL-R group (n = 102) or HDCE-T group (n = 108). The detection rates of colitis-associated dysplasia (CAD) or all colorectal neoplasia from each trial arm were compared.
There was no significant difference in the CAD detection rate between HDCE-T and HDWL-R groups (4/102, 3.9% vs 6/108, 5.6%, P = 0.749). However, HDCE-T showed a trend toward improved colorectal neoplasia detection compared with HDWL-R (21/102, 20.6% vs 13/108, 12.0%, P = 0.093). The median (range) time for colonoscopy withdrawal between the 2 groups was similar (17.6 [7.0-43.3] minutes vs 16.5 [6.3-38.1] minutes; P=0.212; for HDWL-R and HDCE-T, respectively). The total number of biopsies was significantly larger in the HDWL-R group (34 [12-72]) compared with the HDCE-T group (9 [1-20]; P < 0.001).
On the basis of our prospective randomized controlled trial, HDCE-T was not superior to HDWL-R for detecting CADs.
Publisher
Wolters Kluwer,Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
Subject
/ Aged
/ Biopsy
/ Colitis, Ulcerative - complications
/ Colitis, Ulcerative - diagnostic imaging
/ Colitis, Ulcerative - pathology
/ Color
/ Colorectal Neoplasms - diagnosis
/ Colorectal Neoplasms - etiology
/ Colorectal Neoplasms - pathology
/ Coloring Agents - administration & dosage
/ Early Detection of Cancer - methods
/ Female
/ Humans
/ Intestinal Mucosa - diagnostic imaging
/ Intestinal Mucosa - pathology
/ Light
/ Male
/ Patients
/ Tumors
