Detecting diminutive colorectal lesions at colonoscopy: a randomised controlled trial of pan-colonic versus targeted chromoscopy

• DOI: 10.1136/gut.2003.029868
• Publication Date: 2004-02-12T00:43:19Z
• Authors: D P Hurlstone
• Keywords: Adenoma; Adult; Aged, 80 and over; Male; Hyperplasia; Colon; Colonoscopy; Middle Aged; Indigo Carmine; 3. Good health; Disease Progression; Humans; Female; Neoplasm Invasiveness; Colorectal Neoplasms; Coloring Agents; Precancerous Conditions; Aged

<b>Background:</b> Diminutive and flat colorectal lesions can be difficult to detect using conventional colonoscopic techniques. Previous data have suggested that pan-chromoscopy may improve detection rates. No randomised control trial has been performed examining rates of such while controlling for extubation time lavage effect. <b>Aim:</b> We conducted a controlled pan-colonic chromoscopic colonoscopy the diminutive <b>Methods:</b> Consecutive patients attending routine were either 0.5% indigo carmine (IC) or targeted chromoscopy (control group). A minimum diagnostic was set at eight minutes with controls undergoing matched volume saline wash. <b>Results:</b> total 260 randomised; 132 128 chromoscopy. Extubation times did not differ significantly between (median 15 (range 8–41)) 17 8–39)) groups. The IC used in group 68 ml 65–90)) normal (69 60–93)) significantly. There statistically significant difference groups regarding number adenomas detected (p&lt;0.05) more (&lt;4 mm) (p = 0.03). Pan-chromoscopy diagnosed right colon compared (p&lt;0.05), multiple (&gt;3) (p&lt;0.01). Hyperplastic commonly (p&lt;0.001). More hyperplastic polyps left (86% rectosigmoid) controls. <b>Conclusion:</b> Chromoscopy improves enhances lesions. Importantly, had foci high grade dysplasia. benefit patients, assuming risk cancer, help stratification planning follow up intervals.