한빛사 논문
Yang, Dong-Hoon MD, PhD 1; Park, Soo Jung MD, PhD 2; Kim, Hyun-Soo MD, PhD 3; Park, Young Sook MD, PhD 4; Park, Dong Il MD, PhD 5; Lee, Kang-Moon MD, PhD 6; Jung, Sung-Ae MD, PhD 7; Choi, Chang Hwan MD, PhD 8; Koo, Ja Seol MD, PhD 9; Cheon, Jae Hee MD, PhD 2; Yang, Suk-Kyun MD, PhD 1; Kim, Won Ho MD, PhD 2; Kim, Jihun MD, PhD 10; Kim, Hogeun MD, PhD 11; Ryan Choi, Chang-Ho MBBS, PhD 12 Korean Association for the Study of the Intestinal Diseases (KASID) study
1 Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;
2 Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea;
3 Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea;
4 Department of Internal Medicine, Eulji University School of Medicine, Eulji hospital, Seoul, Korea;
5 Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea;
6 Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea;
7 Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea;
8 Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea;
9 Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea;
10 Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;
11 Department of Pathology, Yonsei University College of Medicine, Seoul, Korea;
12 Department of Gastroenterology & Hepatology, St. George Hospital, Sydney, Australia.
Correspondence: Hyun-Soo Kim
Dong-Hoon Yang, MD, PhD and Soo Jung Park, MD, PhD, contributed equally to this work.
Abstract
OBJECTIVES: Although chromoendoscopy is currently the recommended mode of surveillance in patients with long-standing ulcerative colitis, it is technically challenging and requires a long procedure time. The aim of this study was to compare the dysplasia detection rate of high-definition white light endoscopy with random biopsy (HDWL-R) vs high-definition chromoendoscopy with targeted biopsy (HDCE-T).
METHODS: This was a multicenter, prospective randomized controlled trial involving 9 tertiary teaching hospitals in South Korea. A total of 210 patients with long-standing ulcerative colitis were randomized to undergo either the HDWL-R group (n = 102) or HDCE-T group (n = 108). The detection rates of colitis-associated dysplasia (CAD) or all colorectal neoplasia from each trial arm were compared.
RESULTS: There was no significant difference in the CAD detection rate between HDCE-T and HDWL-R groups (4/102, 3.9% vs 6/108, 5.6%, P = 0.749). However, HDCE-T showed a trend toward improved colorectal neoplasia detection compared with HDWL-R (21/102, 20.6% vs 13/108, 12.0%, P = 0.093). The median (range) time for colonoscopy withdrawal between the 2 groups was similar (17.6 [7.0–43.3] minutes vs 16.5 [6.3–38.1] minutes; P=0.212; for HDWL-R and HDCE-T, respectively). The total number of biopsies was significantly larger in the HDWL-R group (34 [12–72]) compared with the HDCE-T group (9 [1–20]; P < 0.001).
DISCUSSION: On the basis of our prospective randomized controlled trial, HDCE-T was not superior to HDWL-R for detecting CADs.
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