Role of Magnification Chromoendoscopy in the Management of Colorectal Neoplastic Lesions Suspicious for Submucosal Invasion.
Dis Colon Rectum
; 62(4): 422-428, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30730457
ABSTRACT
BACKGROUND:
Correctly predicting the depth of tumor invasion in the colorectal wall is crucial for successful endoscopic resection of superficial colorectal neoplasms.OBJECTIVE:
The aim of this study was to assess the accuracy of magnifying chromoendoscopy in a Western medical center to predict the depth of invasion by the pit pattern classification in patients with colorectal neoplasms with a high risk of submucosal invasion.DESIGN:
This single-center retrospective study, from a prospectively collected database, was conducted between April 2009 and June 2015. SETTINGS The study was conducted at a single academic center. PATIENTS Consecutive patients with colorectal neoplasms with high risk of submucosal invasion were included. These tumors were defined by large (≥20 mm) sessile polyps (nonpedunculated), laterally spreading tumors, or depressed lesions of any size.INTERVENTIONS:
Patients underwent magnifying chromoendoscopy and were classified according to the Kudo pit pattern. The therapeutic decision, endoscopic or surgery, was defined by the magnification assessment. MAIN OUTCOMEMEASURES:
Sensitivity, specificity, and positive and negative predictive values of magnifying chromoendoscopy for assessment of these lesions were determined.RESULTS:
A total of 123 lesions were included, with a mean size of 54.0 ± 37.1 mm. Preoperative magnifying chromoendoscopy with pit pattern classification had 73.3% sensitivity, 100% specificity, 100% positive predictive value, 96.4% negative predictive value, and 96.7% accuracy to predict depth of invasion and consequently to guide the appropriate treatment. Thirty-three rectal lesions were also examined by MRI, and 31 were diagnosed as T2 lesions. Twenty two (70.1%) of these lesions were diagnosed as noninvasive by magnifying colonoscopy, were treated by endoscopic resection, and met the curative criteria.LIMITATIONS:
This was a single-center retrospective study with a single expert endoscopist experience.CONCLUSIONS:
Magnifying chromoendoscopy is highly accurate for assessing colorectal neoplasms suspicious for submucosal invasion and can help to select the most appropriate treatment. See Video Abstract at http//links.lww.com/DCR/A920.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Aumento da Imagem
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Neoplasias Colorretais
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Colonoscopia
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Corantes
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Ressecção Endoscópica de Mucosa
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Mucosa Intestinal
Tipo de estudo:
Diagnostic_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
País como assunto:
America do sul
/
Brasil
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article