Endoscopic colorectal imaging and therapy

Silvio W. De Melo, Michael Wallace

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Purpose of review Colorectal cancer screening and prevention is a pivotal element in every gastroenterologist practice. Recent advances in imaging technology and treatment opened the field for endoscopic management of large flat colorectal polyps and early cancer. Recent findings High-definition white light colonoscopy allowed for better characterization of colon polyps, particularly flat lesions. Chromoendoscopy facilitated the identification of colon polyps as well as better endoscopic polyp characterization, with strong correlation with final pathological diagnosis, opening the field of 'virtual' biopsy. One particular technology, confocal endomicroscopy can magnify an image approximately 1000 times resembling optical microscopy with very good correlation with histology. Endoscopic mucosal resection has gained great acceptance to manage flat colorectal polyps with the two major complications being bleeding and perforation, both now under 5% in experienced hands. Endoscopic submucosal resection was developed to increase enbloc resection (less residual disease) of a flat colorectal lesion but one has to accept a higher perforation rate around 10%. Summary Current technology allows for better polyp identification and characterization, which can be managed endoscopically.

Original languageEnglish (US)
Pages (from-to)54-60
Number of pages7
JournalCurrent Opinion in Gastroenterology
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2011

Keywords

  • Chromoendoscopy
  • Confocal endomicroscopy
  • Endoscopic mucosal resection
  • Endoscopic submucosal resection
  • High-definition colonoscopy

ASJC Scopus subject areas

  • Gastroenterology

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