The use of indigocarmine spray increases the colonoscopic detection rate of adenomas.
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.
Togashi
Kazutomo
K
Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Level 9 Ned Hanlon Building, QLD, Australia. ktogashi@jichi.ac.jp
Hewett
David G
DG
Radford-Smith
Graham L
GL
Francis
Leo
L
Leggett
Barbara A
BA
Appleyard
Mark N
MN
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
D004396:Coloring Agents; D007203:Indigo Carmine