| Theme |
The front line of magnifying endoscopy and pit pattern diagnosis -- Now and future |
| Title |
Use of acetic acid in magnification chromo-colonoscopy |
| Author |
Kazutomo Togashi |
Departmenf of Endoscopy, Jichi Medical School / Department of Surgery, Jichi Medical School |
| Author |
Hiroshi Kawamura |
Department of Surgery, Omiya Medical Center, Jichi Medical School |
| Author |
Junichi Sasaki |
Department of Surgery, Omiya Medical Cenfer, Jichi Medical School |
| Author |
Kazuhiro Endo |
Departmenf of Surgery, Jichi Medical School |
| Author |
Koji Yoshizawa |
Departmenf of Surgery, Jichi Medical School |
| Author |
Hisanaga Horie |
Departmenf of Surgery, Jichi Medical School |
| Author |
Fumio Konishi |
Department of Surgery, Omiya Medical Cenfer, Jichi Medical School |
| Author |
Mark Appleyard |
Royal Brisbane and Women's Hospifal, Australia |
| [ Summary ] |
Staining dyes can provide a clear image in magnification colonoscopy, but not instantly. Indigocarmine shows contrast effect instantly, but this effect is not as reliable as staining dyes. Acetic acid is cheap, easily available and safe. It has been used in the evaluation of cervical and esophageal mucosa, but its use has not been evaluated in magnification colonoscopy. We applied acetic acid to magnification chromo-colonoscopy using an indigocarmine spray. Acetic acid causes an acetowhite reaction in epithelial cells and can provide a clearer pit pattern image, as compared to indigocarmine spray. The effect of acetic acid occurs as quickly as that of indigocarmine. Accuracies after using an acetic acid spray were over 95 % with both adenomas and hyperplastic polyps. However, V-N pits are not visible in all submucosally invasive cancers, even if an indigo-carmine spray is sprayed after an acetic acid spray. The use of an acetic acid spray instantly improves pit pattern images during magnification chromo-colonoscopy and improves the accuracy of histological predictions of adenoma or hyperplastic polyp. This method can be easily applied to routine magnification colonoscopy to discriminate adenoma from hyperplastic polyps. |