Off the Cuff Markers: Surveillance and Endoscopic Approaches for Dysplasia After Ileal Pouch-Anal Anastomosis

Barrett, Caroline; Long, Millie D.; Grimm, Ian S.; Herfarth, Hans H; Barnes, Edward L.

doi:10.1007/s10620-022-07669-4

Cited by 3 publications

(1 citation statement)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The overall incidence of neoplasia in the ileal pouch or cuff has been shown in multiple large The American Journal of GASTROENTEROLOGY cohorts to be less than 2% up to 15 years after surgery, although certain risk factors have been consistently identified (72)(73)(74)(75). In patients with an IPAA, a history of colonic and especially rectal dysplasia in the resected colon, PSC and chronic or atrophic pouchitis have been shown to be risk factors for development of dysplasia in the ileal pouch (75)(76)(77)(78). Hence, multiple consensus guidelines recommend these patients undergo annual surveillance (37,39,79,80).…”

Section: Surveillance After Colon Resectionmentioning

confidence: 99%

Update on Endoscopic Dysplasia Surveillance in Inflammatory Bowel Disease

Coelho–Prabhu

2023

Am J Gastroenterol

View full text Add to dashboard Cite

As medical management of inflammatory bowel disease (IBD) makes great advances, most patients with IBD will have long life expectancies without need for total colectomy. With prolonged disease duration, however, there is increased risk of dysplasia leading to colorectal cancer (CRC). Multiple consensus and guideline documents have been published over the last decade with recommendations to optimize early detection and management of dysplastic lesions. Endoscopic technology has improved tremendously, even over the last few years. Previously invisible dysplasia has become visible in most cases with advanced imaging technologies that now allow for much clearer and more detailed mucosal inspection. New tools to facilitate endoscopic resection of visible lesions has also enabled patients to avoid colectomy, with resulting need to continue colon surveillance. There are limited or conflicting data leading to inconsistent recommendations regarding the need for random biopsies, the preferred endoscopic imaging technique and surveillance intervals after resection of dysplasia. Similarly, there remains significant variability in the application of guidelines into daily practice and availability of and training with advanced imaging technologies. Here, we present a narrative review of which patients are at highest risk for dysplasia, the current guidelines on surveillance colonoscopy, factors affecting optimal mucosal visualization, enhanced imaging techniques, standardized reporting terminologies for surveillance colonoscopy, endoscopic management of dysplasia, indications for colectomy, and briefly on future potential technologies to assist in dysplasia detection.

show abstract