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Dye-based chromoendoscopy following polypectomy reduces incomplete polyp resection.

Neil R O'Morain1,2, Mohd I Syafiq1,2, Ammar Shahin1

  • 1Department of Gastroenterology and Clinical Medicine, Tallaght University Hospital, Trinity College Dublin.

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|January 11, 2020
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Summary

Chromoendoscopy using indigo carmine effectively identifies residual polyp tissue after colonoscopy resection. This method improves detection of incomplete resections, enhancing colonoscopy quality and potentially reducing interval cancers.

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Oncology

Background:

  • Polyp resection completeness is crucial for colonoscopy quality and preventing interval cancers.
  • Incomplete resection rates (IRR) range from 6.5% to 22.7%, with higher rates for larger, sessile serrated, or proximal lesions.
  • Chromoendoscopy is increasingly used for polyp detection.

Purpose of the Study:

  • To assess local incomplete resection rates (IRR) after colonoscopy.
  • To determine the efficacy of chromoendoscopy in identifying residual disease post-polypectomy.

Main Methods:

  • A prospective study evaluated post-polypectomy sites using chromoendoscopy with 0.13% indigo carmine.
  • Biopsies were targeted from identified residual disease or taken randomly from clear bases.
  • Reported and histological rates of residual disease were compared.

Main Results:

  • Of 86 evaluated polyp resections (mean age 62.3 years, 54% female), 19.6% had residual disease.
  • Chromoendoscopy correctly identified residual disease in 76.5% of positive cases.
  • Missclassification of polyp bases post-chromoendoscopy was low at 4.6% (OR 0.284, P=0.03).

Conclusions:

  • Indigo carmine chromoendoscopy enhances the early detection of residual disease after polypectomy.
  • This technique can significantly reduce incomplete resection rates, thereby improving colonoscopy quality.