scholarly journals DOP69 The detection with targeted biopsy and characterisation of neoplastic lesions by magnifying chromoendoscopy and NBI in surveillance colonoscopy of patients with ulcerative colitis: a sub-analysis of the Navigator Study

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S071-S072
Author(s):  
K Watanabe ◽  
M Esaki ◽  
S Oka ◽  
F Shimamoto ◽  
M Nishishita ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Surveillance Colonoscopy ◽  
Targeted Biopsy ◽  
Neoplastic Lesions ◽  
Magnifying Chromoendoscopy

scholarly journals P397 Surveillance in ulcerative colitis: Can we predict the risk for intraepithelial neoplasia?

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S368-S369
Author(s):  
J Estorninho ◽  
P Freire ◽  
S Lopes ◽  
M Ferreira ◽  
M Ferreira ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Disease Duration ◽  
Intraepithelial Neoplasia ◽  
Screening Colonoscopy ◽  
Low Grade ◽  
Surveillance Colonoscopy ◽  
High Quality ◽  
Increased Risk ◽  
History Of ◽  
Low Grade Dysplasia

Abstract Background Ulcerative colitis (UC) has been associated with an increased risk of colorectal cancer (CRC). Although dye spray chromoendoscopy showed superiority to standard colonoscopy in surveillance studies, with the availability of higher-resolution colonoscopes, the utility of chromoendoscopy (CE) has been questioned. We aimed to evaluate the risk of intraepithelial neoplasia (IN) after a high-quality screening colonoscopy (making use of CE or random biopsies (RB) and removing all detected lesions) in a population with longstanding UC and to identify potential risk factors for dysplasia incidence. Methods In a previous study, 145 patients with clinically and endoscopic longstanding (≥8 yr) distal/extensive UC without primary sclerosing cholangitis and/or history of IN were prospectively randomised to undergo CE or RB. In this study, after a median follow-up of 5 additional years, we evaluated subsequent IN incidence in these patients, submitted to surveillance colonoscopy. Patients without high-quality surveillance colonoscopy (with good bowel preparation and cecum intubation) using high-definition were excluded. Results One hundred and twenty-one patients were included. Nine had removed adenomas with low-grade dysplasia in the index colonoscopy. Now, in surveillance colonoscopy, we detected 9 (7.4%) IN: low-grade dysplasia was found in 8 (6.6%) patients and a colorectal adenocarcinoma in 1 (0.008%) patient. After multivariate analysis, IN was significantly associated with older age (68 vs. 52 years, p < 0.05) and higher disease duration (26 vs. 20 years, p < 0.05). No association was found between IN and previous detection of IN in screening colonoscopy sex, the CE or RB use in index colonoscopy, extent of disease, The presence of pseudopolyps, smoking habits, familial history of CRC or maintenance therapy for UC. Conclusion In this study, older patients and higher disease duration were associated with a higher risk of IN in surveillance colonoscopy.

scholarly journals Endoscopic Submucosal Dissection for Visible Dysplasia Treatment in Ulcerative Colitis Patients: Cases Series and Systematic Review of Literature

2020 ◽  
Author(s):  
Raffaele Manta ◽  
Angelo Zullo ◽  
Donato Alessandro Telesca ◽  
Danilo Castellani ◽  
Ugo Germani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulcerative Colitis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
R0 Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Pooled Data ◽  
Non Invasive ◽  
Neoplastic Lesions

Abstract Background and Aims Ulcerative colitis [UC] patients are at an increased risk of developing colorectal cancer due to chronic inflammation. Endoscopic submucosal dissection [ESD] allows removal of non-invasive neoplastic lesions in the colon, but few data are available on its efficacy in UC patients. Methods Data from consecutive UC patients diagnosed with visible dysplastic lesions in the colon who underwent ESD were evaluated. The en bloc removal, R0 resection and complication rates were calculated. Local recurrence and metachronous lesions during follow-up were identified. A systematic review of the literature with pooled data analysis was performed. Results A total of 53 UC patients [age: 65 years; range 30–74; M/F: 31/22] underwent ESD. The en bloc resection rate was 100%, and the R0 resection rate was 96.2%. Bleeding occurred in seven [13.2%] patients, and perforation in three [5.6%] cases, all treated at endoscopy. No recurrence was observed, but two metachronous lesions were detected. Data from six other studies [three Asian and three European] were available. By pooling data, en bloc resection was successful in 88.4% (95% confidence interval [CI] = 83.5–92) of 216 lesions and in 91.8% [95% CI = 87.3–94.8] of 208 patients. R0 resection was achieved in 169 ESDs, equivalent to a 78.2% [95% CI = 72.3–83.2] rate for lesions and 81.3% [95% CI = 75.4–86] rate for patients. No difference between European and Asian series was noted. Conclusions This pooled data analysis indicated that ESD is a suitable tool for safely and properly removing non-invasive neoplastic lesions on colonic mucosa of selected UC patients.

Endoscopic Appearances in Predicting Colon Neoplasia in Patients With Ulcerative Colitis on Surveillance Colonoscopy

2014 ◽  
Vol 109 ◽  
pp. S211
Author(s):  
Ramprasad Jegadeesan ◽  
Udayakumar Navaneethan ◽  
Norma Gutierrez ◽  
Madhusudhan Sanaka
Keyword(s):  
Ulcerative Colitis ◽  
Surveillance Colonoscopy ◽  
Colon Neoplasia

Surveillance Colonoscopy for Ulcerative Colitis-Associated Colorectal Cancer Offers Better Overall Survival in Real-World Surgically Resected Cases

2019 ◽  
Vol 114 (3) ◽  
pp. 483-489 ◽  
Author(s):  
Keisuke Hata ◽  
Hiroyuki Anzai ◽  
Hiroki Ikeuchi ◽  
Kitaro Futami ◽  
Kouhei Fukushima ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Overall Survival ◽  
Real World ◽  
Surveillance Colonoscopy

Surveillance in inflammatory bowel disease: an overview

2019 ◽  
Vol 17 (8) ◽  
pp. 32-37
Author(s):  
Sara Koo ◽  
Jignesh Jatania ◽  
Colin Rees
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Duration ◽  
The Other ◽  
Surveillance Colonoscopy ◽  
Targeted Biopsy ◽  
White Light Endoscopy ◽  
Increased Risk ◽  
Inflammatory Bowel

Patients with inflammatory bowel disease (IBD), including both ulcerative colitis and Crohn's disease, are at an increased risk of developing colorectal cancer. It is well accepted that this risk increases after 8–10 years of disease duration. Patients should be offered a surveillance colonoscopy after this time. Previously, white-light endoscopy with random biopsies every 10 cm was undertaken for surveillance, but recent evidence suggests that chromoendoscopy along with targeted biopsy is superior to this and the other available methods. This article reviews the available evidence for IBD surveillance, surveillance guidelines and the evidence for chromoendoscopy. Additionally, an overview of the assessment, reporting of any visible abnormal lesions and management of subsequently proven dysplastic lesions is given.

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