Background and Study Aims: Minute lesions in the colon are of increasing clinical interest. Conventional endoscopic techniques are inadequate for visualizing these lesions, and magnification chromoendoscopy is required to identify them. This study compared the effectiveness of a simpler colon preparation method with the standard technique.
Patients and Methods : Seven patients received dilute methylene blue (0.05 %) by enema prior to the endoscopic evaluation. The extent, quality, and ease of dye delivery were compared with the standard methods.
Results: Dye delivery by enema extended to the splenic flexure and was uniformly applied, and advancement of the endoscope was easier. This alternative method was better tolerated by patients (visual analogue scale 1.9 ± 0.3 vs. 3.8 ± 0.8; P = 0.004).
Conclusion: This rapid and reliable method of visualizing the entire left colon with dye magnification allows magnification chromoendoscopy to be carried out in a convenient manner that is also less painful for the patient.
References
-
1
Nascimbeni R, Villanacci V, Mariani P P. et al .
Aberrant crypt foci in the human colon: frequency and histologic patterns in patients with colorectal cancer or diverticular disease.
Am J Surgical Pathol.
1999;
23
1256-1263
-
2
Muto T, Kamiya J, Sawada T. et al .
Small ”flat adenoma” of the large bowel, with special reference to its clinicopathologic features.
Dis Colon Rectum.
1985;
28
847-851
-
3
Konishi K, Kazuhiro K, Kurahashi T. et al .
A comparison of magnifying and nonmagnifying colonoscopy for diagnosis of colorectal polyps: a prospective study.
Gastrointest Endosc.
2003;
57
48-53
-
4
Bird R P.
Role of aberrant crypt foci in understanding in pathogenesis of colon cancer.
Cancer Lett.
1995;
93
55-71
-
5
Hurlstone D, Fujii T, Lobo A.
Early detection of colorectal cancer using high-magnification chromoscopic colonoscopy.
Br J Surg.
2002;
89
272-282
-
6
Takayama T, Katsuki S, Takahashi Y. et al .
Aberrant crypt foci of the colon as precursors of adenoma and cancer.
N Engl J Med.
1998;
339
1277-1284
-
7
Hilzenrat N, Fich A, Odes S. et al .
Does insertion of a rectal tube after colonoscopy reduce patient discomfort and improve satisfaction?.
Gastrointest Endosc.
2003;
57
54-57
-
8
Yokota T, Sugano K, Kondo H. et al .
Detection of aberrant crypt foci by magnifying colonoscopy.
Gastrointest Endosc.
1997;
46
61-65
-
9
Adler D, Gostout C, Sorbi D. et al .
Endoscopic identification and quantification of aberrant crypt foci in the human colon.
Gastrointest Endosc.
2002;
56
657-662
-
10
Augenlicht L H, Richards C, Corner G, Pretlow T G.
Evidence for genomic instability in human colonic aberrant crypt foci.
Oncogene.
1996;
12
1767-1772
-
11
Heinen C D, Shivapurkar N, Tang Z. et al .
Microsatellite instability in aberrant crypt foci from human colons.
Cancer Res.
1996;
56
5339-5341
-
12
Shpitz B, Bomstein Y, Mekori Y. et al .
Aberrant crypt foci in human colons: distribution and histomorphologic characteristics.
Hum Pathol.
1998;
29
469-475
-
13
Roncucci L, Modica S, Tamassia M. et al .
Aberrant crypt foci in patients with colorectal cancer.
Br J Cancer.
1998;
77
2343-2348
-
14
Winawer S J, Fletcher R H, Miller L. et al .
Colorectal cancer screening: clinical guidelines and rationale.
Gastroenterology.
1997;
112
594-642
-
15
Srivastava S, Verma M, Henson D E.
Biomarkers for early detection of colon cancer.
Clin Cancer Res.
2001;
7
1118-1126
-
16
Keloff G, Sigman C C, Johnson K. et al .
Perspectives on surrogate end points in the development of drugs that reduce the risk of cancer.
Cancer Epidemiol Biomarkers Prev.
2000;
9
127-137
-
17
Reddy B S.
Novel approaches to the prevention of colon cancer by nutritional manipulation and chemoprevention.
Cancer Epidemiol Biomarkers Prev.
2000;
9
239-247
-
18
Lee H L, Kim J W, Cho Y K. et al .
Detection of colorectal adenomas by routine chromoendoscopy with indigo carmine.
Am J Gastroenterol.
2003;
98
1284-1288
-
19
Fujii T, Hasegawa R T, Saitoh Y. et al .
Chromoscopy during colonoscopy.
Endoscopy.
2001;
33
1036-1041
-
20
McLellan E A, Bird R P.
Aberrant crypts: potential preneoplastic lesions in the murine colon.
Cancer Res.
1988;
48
6187-6192
-
21
Sills M, Zinkham W.
Methylene blue-induced Heinz body hemolytic anemia.
Arch Pediatr Adolesc Med.
1994;
148
306-310
R. E. Carroll, M. D.
Dept. of Medicine, University of Illinois at Chicago
840 South Wood Street (M/C 787) · Chicago · IL 60612 · USA
Fax: +1-312-569-8114
Email: rcarroll@uic.edu
