PMID- 32353535
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20210818
IS  - 1542-7714 (Electronic)
IS  - 1542-3565 (Linking)
VI  - 18
IP  - 9
DP  - 2020 Aug
TI  - High-Definition Chromoendoscopy Superior to High-Definition White-Light Endoscopy 
      in Surveillance of Inflammatory Bowel Diseases in a Randomized Trial.
PG  - 2101-2107
LID - S1542-3565(20)30594-2 [pii]
LID - 10.1016/j.cgh.2020.04.049 [doi]
AB  - BACKGROUND & AIMS: There is debate over the optimal method for colonoscopic 
      surveillance of patients with inflammatory bowel diseases. Guidelines recommend 
      chromoendoscopy, but the value of chromoendoscopy in high-definition colonoscopy 
      has not been proven. Furthermore, the value of random biopsies is controversial. 
      METHODS: We performed a prospective study of 305 patients with ulcerative colitis 
      or Crohn's colitis referred for surveillance colonoscopy at a university hospital 
      in Sweden, from March 2011 through April 2016. Patients randomly assigned to a 
      group that received high-definition chromoendoscopy with indigo carmine (HD-CE; 
      n = 152), collection of 32 random biopsies, and targeted biopsies or 
      polypectomies or to a group that received high-definition white light endoscopy 
      (HD-WLE; n = 153), collection of 32 random biopsies, and targeted biopsies or 
      polypectomies. The primary endpoint was number of patients with dysplastic 
      lesions. RESULTS: Dysplastic lesions were detected in 17 patients with HD-CE and 
      7 patients with HD-WLE (P = .032). Dysplasias in random biopsies (n = 9760) were 
      detected in 9 patients: 6 (3.9%) in the HD-CE group and 3 (2.0%) in the HD-WLE 
      group (P = .72). Of the 9 patients with dysplasia, 3 patients (33%) had primary 
      sclerosing cholangitis-only 18% of patients (54/305) included in the study had 
      primary sclerosing cholangitis. The number of dysplastic lesions per 10 min of 
      withdrawal time was 0.066 with HD-CE and 0.027 with HD-WLE (P = .056). 
      CONCLUSIONS: In a randomized trial, we found HD-CE with collection of random 
      biopsies to be superior to HD-WLE with random biopsies for detection of dysplasia 
      per colonoscopy. These results support the use of chromoendoscopy for 
      surveillance of patients with inflammatory bowel diseases. ClinicalTrials.gov no: 
      NCT01505842.
CI  - Copyright (c) 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.
FAU - Alexandersson, Bjarki
AU  - Alexandersson B
AD  - Department of Medicine Solna, Karolinska Institutet, Division of endoscopy, 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Hamad, Yousef
AU  - Hamad Y
AD  - Department of Medicine Solna, Karolinska Institutet, Division of endoscopy, 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Andreasson, Anna
AU  - Andreasson A
AD  - Department of Medicine Solna, Karolinska Institutet, Division of endoscopy, 
      Karolinska University Hospital, Stockholm, Sweden; Stress Research Institute, 
      Stockholm University, Stockholm, Sweden; Department of Psychology, Macquarie 
      University, Sydney, New South Wales, Australia.
FAU - Rubio, Carlos A
AU  - Rubio CA
AD  - Department of Pathology, Karolinska Institutet, Stockholm, Sweden.
FAU - Ando, Yugo
AU  - Ando Y
AD  - Division of Gastroenterology and Hepatology, Third Department of Internal 
      Medicine, Kansai Medical University, Osaka, Japan.
FAU - Tanaka, Kyosuke
AU  - Tanaka K
AD  - Department of Endoscopy, Mie University Hospital, Tsu, Japan.
FAU - Ichiya, Tamaki
AU  - Ichiya T
AD  - Department of Medicine Solna, Karolinska Institutet, Division of endoscopy, 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Rezaie, Reza
AU  - Rezaie R
AD  - Department of Medicine Solna, Karolinska Institutet, Division of endoscopy, 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Schmidt, Peter T
AU  - Schmidt PT
AD  - Department of Medicine Solna, Karolinska Institutet, Division of endoscopy, 
      Karolinska University Hospital, Stockholm, Sweden. Electronic address: 
      peter.thelin.schmidt@ki.se.
LA  - eng
SI  - ClinicalTrials.gov/NCT01505842
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20200427
PL  - United States
TA  - Clin Gastroenterol Hepatol
JT  - Clinical gastroenterology and hepatology : the official clinical practice journal 
      of the American Gastroenterological Association
JID - 101160775
SB  - IM
MH  - *Colitis, Ulcerative
MH  - Colonoscopy
MH  - *Colorectal Neoplasms
MH  - *Crohn Disease
MH  - Humans
MH  - *Inflammatory Bowel Diseases/diagnosis
MH  - Prospective Studies
OTO - NOTNLM
OT  - CD
OT  - IBD
OT  - PSC
OT  - UC
EDAT- 2020/05/01 06:00
MHDA- 2021/08/19 06:00
CRDT- 2020/05/01 06:00
PHST- 2019/12/18 00:00 [received]
PHST- 2020/03/20 00:00 [revised]
PHST- 2020/04/17 00:00 [accepted]
PHST- 2020/05/01 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2020/05/01 06:00 [entrez]
AID - S1542-3565(20)30594-2 [pii]
AID - 10.1016/j.cgh.2020.04.049 [doi]
PST - ppublish
SO  - Clin Gastroenterol Hepatol. 2020 Aug;18(9):2101-2107. doi: 
      10.1016/j.cgh.2020.04.049. Epub 2020 Apr 27.