A new approach to the observation of minute changes of the colonic mucosa by means of magnifying colonoscope, type CF-MB-M (Olympus)

Tada, Masahiro; Misaki, Fumio; Kawai, Keiichi

doi:10.1016/s0016-5107(78)73489-9

Cited by 40 publications

(23 citation statements)

References 2 publications

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“…Following the initial description of colonic chromoscopy by Tada and colleagues, 21 the technique has been applied to many aspects of colonoscopy. Many authors report that chromoscopy is helpful for the detection and detailed morphological assessment of flat and depressed colorectal lesions.…”

Section: Discussionmentioning

confidence: 99%

Detecting diminutive colorectal lesions at colonoscopy: a randomised controlled trial of pan-colonic versus targeted chromoscopy

Hurlstone

2004

Gut

215

129

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Background: Diminutive and flat colorectal lesions can be difficult to detect using conventional colonoscopic techniques. Previous data have suggested that pan-chromoscopy may improve detection rates. No randomised control trial has been performed examining detection rates of such lesions while controlling for extubation time and lavage effect. Aim: We conducted a randomised controlled trial of pan-colonic chromoscopic colonoscopy for the detection of diminutive and flat colorectal lesions while controlling for extubation time and lavage effect. Methods: Consecutive patients attending for routine colonoscopy were randomised to either panchromoscopy using 0.5% indigo carmine (IC) or targeted chromoscopy (control group). A minimum diagnostic extubation time was set at eight minutes with controls undergoing a matched volume of saline wash. Results: A total of 260 patients were randomised; 132 controls and 128 to pan-colonic chromoscopy. Extubation times did not differ significantly between the control (median 15 minutes (range 8-41)) and chromoscopy (median 17 minutes (range 8-39)) groups. The volume of IC used in the pan-chromoscopy group (median 68 ml (range 65-90)) and normal saline used in the control group (69 ml (range 60-93)) did not differ significantly. There was a statistically significant difference between the groups regarding the total number of adenomas detected (p,0.05) with significantly more diminutive (,4 mm) adenomas detected in the pan-chromoscopy group (p = 0.03). Pan-chromoscopy diagnosed more diminutive and flat lesions in the right colon compared with controls (p,0.05), with more patients with multiple adenomas (.3) detected using pan-chromoscopy (p,0.01). Hyperplastic lesions were more commonly detected in the pan-chromoscopy group compared with controls (p,0.001). More hyperplastic polyps were detected in the left colon (86% rectosigmoid) using chromoscopy compared with controls. Conclusion: Chromoscopy improves the total number of adenomas detected and enhances the detection of diminutive and flat lesions. Importantly, eight diminutive lesions had foci of high grade dysplasia. Chromoscopy may benefit patients, assuming a high risk of colorectal cancer, and help in risk stratification and planning follow up colonoscopy intervals.

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Section: Discussionmentioning

confidence: 99%

Detecting diminutive colorectal lesions at colonoscopy: a randomised controlled trial of pan-colonic versus targeted chromoscopy

Hurlstone

2004

Gut

215

129

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“…Since Dehyle et al reported the first snare polypectomy and endoscopic mucosal resection series in 1971 [3] and in 1972 [2], respectively, advances in colonoscopic instruments and techniques [5,14,16] have resulted in the widespread acceptance and increasing use of endoscopic resection of colorectal polyps. Endoscopic resection plays an important role in the treatment of colorectal tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Advances in colonoscopic instruments and techniques have resulted in greater numbers of endoscopic resections being performed for colorectal neoplasms including mucosal and submucosal invasive cancer [5,14,16]. Complete resection of mucosal cancer is thought to be curative because there is no risk of nodal metastasis [12].…”

mentioning

confidence: 99%

Endoscopic resection for submucosally invasive colorectal cancer

et al. 1999

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“…The first reports on the pit patterns of the colorectal mucosa were made from studies of normal colorectal mucosa by Bank et al (20) and Tada et al (21). Subsequently, reports of the pit patterns in colorectal tumors began to be published (11).…”

Section: Discussionmentioning

confidence: 99%

Sub-classification of type VI pit patterns in colorectal tumors: relation to the depth of tumor invasion

Tobaru

Mitsuyama²,

Takahashi³

et al. 1992

Int J Oncol

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Abstract. We analyzed pit patterns of colorectal tumors with magnifying colonoscopy, focusing on the relationship between the V I pattern sub-classification and the depth of tumor invasion. The V I pattern was divided into the well-demarcated and poorly demarcated subtypes. The percentage of tumors with a depth of invasion of over 1,000 μm was in the order of non-V types (type I-IV) < type V I < type V N . Most welldemarcated V I lesions (80.8%) showed a depth of invasion of <1,000 μm compared to only 21.1% of poorly demarcated V I lesions. Both the frequency of degeneration or prolapse of the epithelial lining and the frequency of desmoplastic reaction occurred in the order of non-V types < type V I < type V N , while the degree of histological differentiation and the frequency of residual muscularis mucosae occurred in the order of non-V types > type V I > type V N . Furthermore, the poorly demarcated V I subtype showed a higher frequency of epithelial lining degeneration or prolapse and a lower frequency of residual muscularis mucosae than the welldemarcated V I subtype. Tumors with a depth of invasion of >1,000 μm showed a higher frequency of epithelial lining degeneration or prolapse, a lower degree of histological differentiation, a higher frequency of desmoplastic reaction, and a lower frequency of residual muscularis mucosae than did tumors with <1,000 μm of invasion. These results suggest that V I pit pattern sub-classification is a useful indicator of the depth of colorectal tumor invasion and treatment selection. A prospective study on this subject would be useful.

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A new approach to the observation of minute changes of the colonic mucosa by means of magnifying colonoscope, type CF-MB-M (Olympus)

Cited by 40 publications

References 2 publications

Detecting diminutive colorectal lesions at colonoscopy: a randomised controlled trial of pan-colonic versus targeted chromoscopy

Detecting diminutive colorectal lesions at colonoscopy: a randomised controlled trial of pan-colonic versus targeted chromoscopy

Endoscopic resection for submucosally invasive colorectal cancer

Sub-classification of type VI pit patterns in colorectal tumors: relation to the depth of tumor invasion

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