Colonoscopy: New approaches to better outcomes

Susan G. Coe, Michael B. Wallace

Research output: Contribution to journalReview article

7 Scopus citations

Abstract

Purpose of review: Prevention of colorectal cancer relies on the detection and removal of colorectal neoplasia. Recent advances in mucosal imaging and inspection techniques have increased the detection of small and diminutive colorectal polyps with unknown clinical impact. The ability to accurately predict whether a polyp is neoplastic may allow for an optical triage approach to polyp management, improving efficiency while reducing the cost and risk of polypectomy. Recent findings: High-definition white light colonoscopy, cap-fitted colonoscopy, and dye-based pan-chromoendoscopy have each shown to increase polyp detection. Virtual chromoendoscopy, although not beneficial for polyp detection, allows for accurate in-vivo prediction of polyp pathology. Endoscopists' behaviors, independent of patient factors, strongly influence adenoma detection. Training methods focused on the techniques of high adenoma detectors also increase adenoma and polyp detection. Summary: Advances in mucosal imaging and improvements in inspection technique have allowed us to detect more polyps and to predict their pathology with greater accuracy. An optical triage approach to either 'diagnose and discard' or 'diagnose and leave behind' has the potential to reduce the risk and cost of polypectomy.

Original languageEnglish (US)
Pages (from-to)70-75
Number of pages6
JournalCurrent Opinion in Gastroenterology
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2012

Keywords

  • Chromoendoscopy
  • Mucosal imaging
  • Optical triage

ASJC Scopus subject areas

  • Gastroenterology

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