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 21 May 2018

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News

Chromoendoscopy for surveillance in ulcerative colitis and Crohn’s disease

The most recent issue of the Clinical Gastroenterology & Hepatology investigates chromoendoscopy for surveillance in ulcerative colitis and Crohn’s disease.

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Key international guideline agencies recommend dysplasia surveillance in inflammatory bowel diseases with chromoendoscopy.

Dr Andrea Iannone and colleagues from the United Kingdom performed a systematic review of randomized trials comparing chromoendoscopy vs other endoscopic techniques for dysplasia surveillance in inflammatory bowel diseases.

The team searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for relevant studies published through 2016.

The researchers estimated risk ratios for dichotomous outcomes, mean differences for continuous outcomes.

Subgroup analyses included technique compared with chromoendoscopy, type of disease, and type of dye.

Chromoendoscopy required a longer procedural time compared with other techniques
Clinical Gastroenterology & Hepatology

The team estimated sensitivity and specificity of the techniques with reference to histology.

The research team identified 10 randomized trials.

There was a higher likelihood of detecting patients with dysplasia with chromoendoscopy compared with other techniques.

Subgroup analyses confirmed this effect only if chromoendoscopy was compared with standard-definition white-light endoscopy.

The team noted that chromoendoscopy required a significantly longer procedural time compared with other techniques.

There was no difference in the likelihood of detecting dysplastic subtypes and dysplasia by targeted biopsies between groups.

Test sensitivity and specificity were similar between groups.

Dr Iannone's team concludes, "In surveillance of inflammatory bowel diseases, chromoendoscopy identifies more patients with dysplasia only when compared with standard-definition white-light endoscopy."

"It is associated with longer procedural time with no direct evidence of effect on preventing all-cause/cancer-specific mortality or time to interval cancer."

Clin Gastroenterol Hepatol 2017: 15(11): 1684–1697.e11
31 October 2017

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