title: The use of indigocarmine spray increases the colonoscopic detection rate of adenomas.
abstract: OBJECTIVE
  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 <or=5 mm.
  
  
  CONCLUSIONS
  Chromocolonoscopy increases the detection of neoplastic polyps and flat adenomas, particularly diminutive polyps, but does not increase the detection of advanced lesions.
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Level 9 Ned Hanlon Building, QLD, Australia. ktogashi@jichi.ac.jp
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Togashi
authors.forename: David G
authors.initials: DG
authors.lastname: Hewett
authors.forename: Graham L
authors.initials: GL
authors.lastname: Radford-Smith
authors.forename: Leo
authors.initials: L
authors.lastname: Francis
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Leggett
authors.forename: Mark N
authors.initials: MN
authors.lastname: Appleyard
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis / Q000473:pathology; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007203:Indigo Carmine; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D004396:Coloring Agents; D007203:Indigo Carmine