Abstract

Increasing the yield of the high-resolution anoscopy with endoscopic assistance: A Gastroenterologist’s Perspective

Highlights

  • Colonoscopy is the best tool for the colorectal cancer screening

  • Among the remaining 7 patients who had no high-grade anal lesion on the index High resolution anoscopy (HRA); three patients had no aceto-whitness on HRA and 4 patients had a non-dysplastic pathology on biopsies. 6 patients among this group with negative index HRA underwent endoscopy assisted high-resolution anoscopy (eHRA). 5 out of these 6 patients (83%) were noted to have high-grade squamous intraepithelial lesion (HSIL) and 1 patient had low grade squamous intraepithelial lesion (LSIL)

  • The endoscopy assisted high resolution anoscopy can increase the yield of detecting HSIL

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Summary

Introduction

Colonoscopy is the best tool for the colorectal cancer screening. It is a chartered territory of gastroenterologists [1]. The sole concept is identification of lesions that are precursors to colon cancer. Highresolution anoscopy (HRA) as performed for the evaluation of anal dysplasia is an unchartered territory of the gastroenterologist [2]. Patients with HIV, MSM (men having sex with men) and woman with high-grade genital lesions should be evaluated for human papillomavirus (HPV) related anal dysplasia [3]. There is an increase in the rates of the Human Papilloma virus (HPV) related anal cancer in human immunodeficiency virus (HIV) positive individuals. High resolution anoscopy (HRA) is performed for the further evaluation of the abnormal anal cytology. Acquiring HRA skills and using a microscope to increase the yield has a steep learning curve, and leaving most gastroenterologists untrained in this examination

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