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Colonoscopy Surveillance and Management of Dysplasia in Inflammatory Bowel Disease
Tonya Kaltenbach1, Gisele Leite2, Roy Soetikno3
1Veterans Affairs Palo Alto Health Care System, Stanford University School of Medicine, 3801 Miranda Ave, GI111, Palo Alto, CA, 94304, USA. endoresection@me.com.
Opinion Statement:
Patients with long-standing ulcerative colitis (UC) and extensive Crohn's disease (CD) colitis have a high risk of colorectal cancer (CRC) and are recommended to undergo surveillance with colonoscopy. Recent data highlights their increased risk of CRC compared to the general population despite colonoscopy surveillance. The proportion of IBD patients diagnosed with interval CRC within 6 to 36 months following a clearing colonoscopy was 15 %. Optimizing colonoscopy surveillance methods is important. Studies have demonstrated that the best endoscopic surveillance strategy to detect dysplasia is chromoendoscopy with surface application of dyes to enhance the mucosal visualization and that visible dysplasia should be endoscopically resected. In this chapter we will summarize the optimal surveillance and management techniques for colorectal dysplasia in IBD patients.
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