Novel diagnostic and therapeutic techniques for surveillance of dysplasia in patients with inflammatory bowel disease

M. Iacucci, T. Uraoka, M. Fort Gasia, Naohisa Yahagi

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The risk for developing dysplasia and colorectal cancer in patients with longstanding inflammatory bowel disease (IBD) involving the colon is well documented. Random biopsies during white-light, standard-definition colonoscopy (33 to 50 biopsies) with or without dye spraying chromoendoscopy has been the recommended strategy in North America to detect dysplastic lesions in IBD. However, there are several limitations to this approach including poor physician adherence, poor sensitivity, increased procedure time and considerable cost. The new generation of high-definition endoscopes with electronic filter technology provide an opportunity to visualize colonic mucosal and vascular patterns in minute detail, and to identify subtle flat, multifocal, polypoid and pseudopolypoid neoplastic and non-neoplastic lesions. The application of these new technologies in IBD is slowly being adopted in clinical practice. In addition, the advent of confocal laser endomicroscopy provides an opportunity to explore real-time histology, thus redefining the understanding and characterization of the lesions in IBD. There is emerging evidence that serrated adenomas are also associated with longstanding IBD colitis and may be recognized as another important contributing factor to colorectal cancer development. The circumscribed neoplastic lesions can be treated using endoscopic therapeutic management such as mucosal resection or, especially, endoscopic submucosal dissection. This may replace panproctocolectomy in selected patients. The authors review the potential of these techniques to transform endoscopic diagnosis and therapeutic management of dysplasia in IBD.

Original languageEnglish
Pages (from-to)361-370
Number of pages10
JournalCanadian Journal of Gastroenterology and Hepatology
Volume28
Issue number7
Publication statusPublished - 2014

Fingerprint

Inflammatory Bowel Diseases
Colorectal Neoplasms
Therapeutics
Technology
Biopsy
Endoscopes
Colitis
Colonoscopy
North America
Adenoma
Blood Vessels
Histology
Colon
Lasers
Coloring Agents
Physicians
Light
Costs and Cost Analysis

Keywords

  • Chromoendoscopy
  • Confocal laser endomicroscopy
  • Endoscopic submucosal dissection
  • High-definition endoscopic technique - iScan
  • Inflammatory bowel disease
  • Narrow band imaging

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Novel diagnostic and therapeutic techniques for surveillance of dysplasia in patients with inflammatory bowel disease. / Iacucci, M.; Uraoka, T.; Fort Gasia, M.; Yahagi, Naohisa.

In: Canadian Journal of Gastroenterology and Hepatology, Vol. 28, No. 7, 2014, p. 361-370.

Research output: Contribution to journalArticle

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