INTESTINE Vol.24 No.4(2-1)

Theme Master the magnifying endoscopy for colorectal neoplasms
Title Strategy and art of magnifying colonoscopy for colorectal neoplasia
Publish Date 2020/11
Author Hidenori Tanaka Department of Endoscopy, Hiroshima University Hospital
Author Shinji Tanaka Department of Endoscopy, Hiroshima University Hospital
Author Yuki Okamoto Department of Endoscopy, Hiroshima University Hospital
Author Ken Yamashita Department of Endoscopy, Hiroshima University Hospital
Author Yuki Ninomiya Department of Endoscopy, Hiroshima University Hospital
Author Kyoku Sumimoto Department of Endoscopy, Hiroshima University Hospital
Author Nana Hayashi Department of Endoscopy, Hiroshima University Hospital
Author Shiro Oka Department of Gastroenterology and Metabolism, Hiroshima University Hospital
Author Kazuaki Chayama Department of Gastroenterology and Metabolism, Hiroshima University Hospital
[ Summary ] Pit pattern diagnosis using magnifying chromoendoscopy and narrow band imaging (NBI) or blue laser imaging (BLI) magnification with JNET classification, provides more objective findings compared to white light imaging (WLI) observations, and are useful for histopathologic diagnosis and invasion depth prediction of colorectal neoplasia. NBI/BLI magnification, which can be performed easily, should be performed as a screening modality before pit pattern diagnosis using magnifying chromoendoscopy. If a lesion is diagnosed JNET Type 2B, or any other type with low confidence by NBI/BLI magnification, an additional pit pattern diagnosis using magnifying chromoendoscopy is necessary for precise diagnosis and selecting an appropriate treatment option. Magnification is now an indispensable skill for endoscopists to manage colorectal neoplasia. It is important to learn how to wash out mucus from the surface of the tumor, the procedure of magnification, the colonoscope operation to take an appropriate image, and the correct interpretation of the magnified image.
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