Abstract
Introduction: Chromocolonoscopy has become an increasingly recognized method to detect dysplasia in patients with inflammatory bowel disease (IBD). IBD patients with risk factors for dysplasia are offered chromocolonoscopy as part of their screening/surveillance colonoscopy. A retrospective review of our initial experience with a case control comparison of procedure performance was conducted.2790 Figure 1 No Caption available.Methods: A retrospective study was completed at Mayo Clinic in Arizona comparing a cohort of IBD patients undergoing chromocolonoscopy to historical controls with IBD undergoing screening, surveillance or dysplasia evaluation by the same 5 expert colonoscopists. We had 37 cases from 3/2015-6/2017 and 134 controls from 1/2012-2/2015. Of the 37 cases, 10 were for Lynch Syndrome or colorectal neoplasia alone, leaving 27 IBD cases for analysis. Indications in the 27 IBD patients were: known dysplasia evaluation, screening or surveillance in high risk patients. Pancolonic application of indigo carmine, 2g/liter, was used. All dysplasia was confirmed by expert GI pathologists. Results: The results show that the mean withdrawal times were 29.6 min. (SE 8.44 min) vs 19.2 min (SE 8.79 min), P The yield of targeted versus random biopsies for dysplasia and adenomatous polyps were compared in patients who underwent chromocolonoscopy (Table1). Three patients had dysplasia detected on random biopsies. Conclusion: This data suggests that targeted biopsies are valuable, but do not find all instances of dysplasia and may not be a replacement for random biopsies at this time. Until further refinements in the procedure are developed, we recommend taking random biopsies in addition to targeted biopsies in patients getting chromocolonoscopy. In addition, chromocolonoscopy in IBD takes longer than routine colonoscopy and this should be considered when scheduling these procedures.
Published Version
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