High resolution colonoscopy with chromoscopy versus standard colonoscopy for the detection of colonic neoplasia: a randomized study.
OBJECTIVE
High-resolution colonoscopy with chromoscopy (HRC) is a technique designed to improve the detection of colonic neoplasias. We prospectively compared standard colonoscopy (SC) and HRC in a randomized multicenter trial.


METHODS
Patients (n = 203; age, 58 +/- 10 years; sex ratio, 1) were recruited according to the following criteria: (1) a history of either familial or personal colonic neoplasia or (2) alarm symptoms after the age of 60 years. After randomization, an SC was performed in 100 patients (resolution, < or = 410,000 pixels) and a HRC in 103 patients (Fujinon EC485ZW, 850,000 pixels). In the HRC group, each colonic segment was examined before and after spraying with indigo carmine 0.4%.


RESULTS
Two hundred seventy-six polyps were detected in 198 patients. One hundred sixty of them were hyperplastic polyps, 116 were adenomas, and 2 were carcinomas. The numbers of hyperplastic polyps and purely flat adenomas were significantly higher in the HRC group than in the SC group (1.1 +/- 1.6 vs 0.5 +/- 1.4 and 0.22 +/- 0.68 vs 0.07 +/- 0.29, respectively; P = .01 and P = .04), but there was no significant difference in the total number of adenomas per patient (primary end point) detected between the HRC and the SC groups (0.6 +/- 1.0 vs 0.5 +/- 0.9, respectively).


CONCLUSIONS
Although HRC improves detection of purely flat adenomas and hyperplastic polyps, the overall detection of colonic adenomas in a population at increased risk of neoplasia is not significantly improved. These findings do not support the routine use of HRC in clinical practice.
Le Rhun
Marc
M
Digestive Diseases Institute, University Hospital Hôtel-Dieu, Nantes, France.
Coron
Emmanuel
E
Parlier
David
D
Nguyen
Jean-Michel
JM
Canard
Jean-Marc
JM
Alamdari
Afchine
A
Sautereau
Denis
D
Chaussade
Stanislas
S
Galmiche
Jean-Paul
JP
D000236:Adenoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D005260:Female; D005602:France; D006801:Humans; D007089:Image Enhancement; D007203:Indigo Carmine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D004396:Coloring Agents; D007203:Indigo Carmine