High-Definition Chromoendoscopy Versus High-Definition White Light Colonoscopy for Neoplasia Surveillance in Ulcerative Colitis: A Randomized Controlled Trial. (October 2019)

• Record Type: Journal Article
• Authors: Yang, Dong-Hoon; Park, Soo Jung; Kim, Hyun-Soo; Park, Young Sook; Park, Dong Il; Lee, Kang-Moon; Jung, Sung-Ae; Choi, Chang Hwan; Koo, Ja Seol; Cheon, Jae Hee; Yang, Suk-Kyun; Kim, Won Ho; Kim, Jihun; Kim, Hogeun; Ryan Choi, Chang-Ho
• Is Part Of: American journal of gastroenterology. Volume 114:Number 10(2019)
• Publication Date: 2019-10
• Subjects: Stomach -- Diseases -- Periodicals; Intestines -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Gastrointestinal Diseases -- Periodicals; Electronic journals; Periodicals; 616.33
• DOI: 10.14309/ajg.0000000000000341
• Languages: English
• ISSNs: 0002-9270

Abstract

Abstract : OBJECTIVES: Although chromoendoscopy is currently the recommended mode of surveillance in patients with long-standing ulcerative colitis, it is technically challenging and requires a long procedure time. The aim of this study was to compare the dysplasia detection rate of high-definition white light endoscopy with random biopsy (HDWL-R) vs high-definition chromoendoscopy with targeted biopsy (HDCE-T). METHODS: This was a multicenter, prospective randomized controlled trial involving 9 tertiary teaching hospitals in South Korea. A total of 210 patients with long-standing ulcerative colitis were randomized to undergo either the HDWL-R group (n = 102) or HDCE-T group (n = 108). The detection rates of colitis-associated dysplasia (CAD) or all colorectal neoplasia from each trial arm were compared. RESULTS: There was no significant difference in the CAD detection rate between HDCE-T and HDWL-R groups (4/102, 3.9% vs 6/108, 5.6%, P = 0.749). However, HDCE-T showed a trend toward improved colorectal neoplasia detection compared with HDWL-R (21/102, 20.6% vs 13/108, 12.0%, P = 0.093). The median (range) time for colonoscopy withdrawal between the 2 groups was similar (17.6 [7.0–43.3] minutes vs 16.5 [6.3–38.1] minutes; P= 0.212; for HDWL-R and HDCE-T, respectively). The total number of biopsies was significantly larger in the HDWL-R group (34 [12–72]) compared with the HDCE-T group (9 [1–20]; P < 0.001). DISCUSSION: On the basis of our prospective randomized controlled trial, HDCE-T was not superior to HDWL-R for detecting CADs.