Panchromoendoscopy Increases Detection of Polyps in Patients With Serrated Polyposis Syndrome

López-Vicente, Jorge; Rodríguez‐Alcalde, Daniel; Hernández, Luis; Pons, Fausto Riu; Vega, Pablo; Rivas, Jesus Miguel Herrero; García, José Santiago; Franco, Inmaculada Salces; Balén, M Bustamante; López-Cerón, María; Pellisé, María

doi:10.1016/j.cgh.2018.10.029

Cited by 15 publications

(13 citation statements)

References 24 publications

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“…As a consequence, underestimation of polyp size rather than missing large polyps during WLE may explain our finding of larger polyps detected by CE. Of note, similar findings were reported in two previous colorectal CE studies, demonstrating a trend towards larger adenomas detected by CE [19,20]. It is important to note that detection of polyps larger than 10 mm leads to a change in clinical decision-making.…”

Section: Gastric Findings Wle Ce P Valuesupporting

confidence: 87%

Dye chromoendoscopy leads to a higher adenoma detection in the duodenum and stomach in patients with familial adenomatous polyposis

et al. 2020

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Backround and study aims Duodenal cancer is the cancer most often seen in patients with familial adenomatous polyposis (FAP) who have undergone risk-reducing colonic surgery. Almost all patients with FAP eventually develop duodenal adenomas and risk for duodenal cancer is up to 12 % with poor prognosis. In addition, there is a rising concern regarding increased gastric cancer risk in patients with FAP. Our aim was to enhance polyp detection by using CE (CE) with the application of indigo carmine dye. Patient and methods We conducted a prospective, blinded study of patients with FAP undergoing endoscopic examination of the upper gastrointestinal tract. First, a standard white-light examination (WLE) was done followed by an examination performed by an endoscopist who was blinded to the previous examination, using chromoendoscopy (CE) (0.4 % indigo carmine dye). Results Fifty patients were included in the study. Using WLE, a median number of 13 adenomas (range 0–90) was detected compared to 23 adenomas/patient (range 0–150; P < 0.0001) detected after staining, leading to a higher Spigelman stage in 16 patients (32 %; P = 0.0003). CE detected significantly more larger adenomas (> 10 mm) than WLE (12 vs. 19; P = 0.0391). In the gastric antral region, a median number of 0 adenomas (range 0–6) before and 0.5 adenomas (range 0–7) after staining (P = 0.0025) were detected. Conclusion This prospective endoscopic trial, to our knowledge the largest in patients with FAP, showed a significant impact of CE on adenoma detection and therapeutic management in the upper gastrointestinal tract. This leads to more intensive surveillance intervals.

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Section: Gastric Findings Wle Ce P Valuesupporting

confidence: 87%

Dye chromoendoscopy leads to a higher adenoma detection in the duodenum and stomach in patients with familial adenomatous polyposis

et al. 2020

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“…Recently, a multicenter randomized controlled trial (RCT) evaluated the usefulness of conventional chromoendoscopy with indigo carmine for the detection of colonic polyps in SPS [145]. This study demonstrated a significantly higher additional polyp detection rate in the HD chromoendoscopy group (0.39; 95 %CI 0.35 -0.44) than in the HD-WLE group (0.22; 95 %CI 0.18 -0.27; P < 0.001).…”

Section: Advanced Imaging In Colonoscopy Surveillancementioning

confidence: 97%

Endoscopic management of polyposis syndromes: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

et al. 2019

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Main RecommendationsESGE recommends that individuals with hereditary gastrointestinal polyposis syndromes should be surveilled in dedicated units that provide monitoring of compliance and endoscopic performance measures. Strong recommendation, moderate quality of evidence, level of agreement 90 %.ESGE recommends performing esophagogastroduodenoscopy, small-bowel examination, and/or colonoscopy earlier than the planned surveillance procedure if a patient is symptomatic. Strong recommendation, low quality of evidence, level of agreement 100 %.

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“…In a previous study in an organized CRC-screening population, we demonstrated that a reassessment colonoscopy within a year, specially directed to detect serrated lesions and performed by aware and dedicated endoscopists, tripled the prevalence of SPS in this cohort [11]. We also recently reported in a multicenter randomized crossover study that dye-based panchromoendoscopy detected twofold more serrated lesions than conventional endoscopy during surveillance colonoscopy of previously cleared SPS patients [31]. Chromoendoscopy was found to be especially useful in detecting flat and subtle polyps, such as small serrated lesions, and added little value for the detection of adenomas (usually darker than surrounding mucosa) and large polyps [30].…”

Section: Discussionmentioning

confidence: 55%

Endocuff-assisted colonoscopy for surveillance of serrated polyposis syndrome: a multicenter randomized controlled trial

Rivero‐Sánchez

López-Vicente

Villalba³

et al. 2019

Endoscopy

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Background and study aims Serrated polyposis syndrome (SPS) is a condition with high risk for colorectal cancer. The Endocuff device has been shown to increase adenoma detection in the general and screening population. We aimed to ascertain whether Endocuff-assisted colonoscopy increases detection of serrated lesions in comparison with standard colonoscopy during the surveillance of patients with SPS. Methods In a multicenter randomized controlled study, patients who met SPS criteria I and/or III under surveillance (previous resection of all serrated lesions ≥ 4 mm) were consecutively randomly allocated 1:1 to Endocuff-assisted colonoscopy or standard colonoscopy, performed by expert endoscopists. The main outcome was the mean number of serrated lesions detected per patient. Results 122 patients (standard colonoscopy n = 60; Endocuff-assisted colonoscopy n = 62; 59 % men; mean age 60.6 (standard deviation [SD] 7.5) were included at 4 centers. Baseline variables (demographic data, SPS phenotype, colorectal cancer [CRC] history, cumulative polyps, and follow-up), cecal intubation rate, and withdrawal time were similar between groups. There was no statistically significant difference between Endocuff-assisted colonoscopy and standard colonoscopy for the mean number of serrated lesions detected per patient: 5.8 (95 % confidence interval [95 %CI] 4.4 – 7.2) and 5.0 (3.9 – 6.1), respectively (P = 0.36). There were also no differences between Endocuff-assisted and standard colonoscopy for detection of sessile serrated lesions (mean number per patient 2.5 [1.3 – 3.6] vs. 2.0 [1.1 – 3.0], P = 0.54) and adenomas (0.9 [0.5 – 1.3] vs. 0.5 [0.3 – 0.7], P = 0.12). Conclusion Use of Endocuff-assisted colonoscopy did not significantly increase the number of serrated lesion detected per patient during surveillance of SPS.

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Panchromoendoscopy Increases Detection of Polyps in Patients With Serrated Polyposis Syndrome

Cited by 15 publications

References 24 publications

Dye chromoendoscopy leads to a higher adenoma detection in the duodenum and stomach in patients with familial adenomatous polyposis

Dye chromoendoscopy leads to a higher adenoma detection in the duodenum and stomach in patients with familial adenomatous polyposis

Endoscopic management of polyposis syndromes: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Endocuff-assisted colonoscopy for surveillance of serrated polyposis syndrome: a multicenter randomized controlled trial

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