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The use of indigocarmine spray increases the colonoscopic detection rate of adenomas

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Abstract

Purpose

It remains controversial whether chromocolonoscopy using indigocarmine increases the detection of colorectal polyps. We aimed to assess the impact of indigocarmine dye spray on the detection rate of adenomas and the feasibility of learning the technique in a Western practice.

Methods

400 patients were prospectively allocated into 2 groups; A (n = 200): indigocarmine chromocolonoscopy was performed by a Japanese colonoscopist with expertise in chromoscopy; B (n = 200): initial 100 patients (B-1), a Western colonoscopist with no previous experience of chromoscopy performed conventional colonoscopy, but with at least 10 min observation during colonoscopy withdrawal. In the next 100 patients (B-2), he performed chromocolonoscopy. All polyps found were resected. Regression analysis was used to compare the numbers of polyps detected in groups A, B-1 and B-2, whilst controlling for gender, age, indication and history of colorectal cancer.

Results

There were significant differences in the numbers of neoplastic polyps and flat adenomas between groups A and B-1 as well as between B-1 and B-2, but not between A and B-2. There was no significant difference in numbers of advanced lesions. Chromocolonoscopy (A and B-2) detected more neoplastic polyps of ≤5 mm.

Conclusion

Chromocolonoscopy increases the detection of neoplastic polyps and flat adenomas, particularly diminutive polyps, but does not increase the detection of advanced lesions.

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Acknowledgments

Grant support was received in part by Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan. The authors wish to thank Nirmala Pandeya (Queensland Institute of Medical Research) for assistance with statistical analysis, the staff of the endoscopy units at the Royal Brisbane and Women’s Hospital and the Prince Charles Hospital, and Professors Fumio Konishi and Hideo Nagai (Jichi Medical University) for providing the first author (KT) with the opportunity to undertake this work.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Royal Brisbane and Women’s Hospital, Level 9 Ned Hanlon Building, Herston, QLD, 4029, Australia

    Kazutomo Togashi, David G. Hewett, Graham L. Radford-Smith, Barbara A. Leggett & Mark N. Appleyard

  2. Department of Anatomical Pathology, Royal Brisbane and Women’s Hospital, Herston, QLD, 4029, Australia

    Leo Francis

  3. Department of Endoscopy and Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Kazutomo Togashi

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  1. Kazutomo Togashi
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  2. David G. Hewett
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  3. Graham L. Radford-Smith
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  4. Leo Francis
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  5. Barbara A. Leggett
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Correspondence to Kazutomo Togashi.

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Togashi, K., Hewett, D.G., Radford-Smith, G.L. et al. The use of indigocarmine spray increases the colonoscopic detection rate of adenomas. J Gastroenterol 44, 826–833 (2009). https://doi.org/10.1007/s00535-009-0065-3

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  • DOI: https://doi.org/10.1007/s00535-009-0065-3

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