Using of acetic acid chromoendoscopy for the diagnosis of serrated colon polyps

Ageykina, N.; Fedorov, E.; Malkov, P.; Oleynikova, N.; Danilova, N.; Kharlova, O.; Korolev, Y.

Авторы: Ageykina N., Fedorov E., Malkov P., Oleynikova N., Danilova N., Kharlova O., Korolev Y.
Журнал: Endoscopy
Том: 52
Год издания: 2020
Издательство: Georg Thieme Verlag
Местоположение издательства: Germany
Первая страница: 171
Последняя страница: 171
Номер статьи: ePP134
DOI: 10.1055/s-0040-1704528
Аннотация: Aims To increase the efficiency of endoscopic diagnosis of serrated colonpolyps during colonoscopyMethods 71 polyps were detected in 57 patients in all parts of the colon: 27(38%) – < 5 mm; 36(50,7%)- 6-10 mm; 8(11,3%) – > 10 mm. The macroscopictype was 0-IIа −50(70,2%), 0-Is −21 (29,5). During colonoscopy, 1.5%-aceticacid, 5 ml, was sprayed onto the identified polyps. Mucosa was observed endoscopicallyfor 2 minutes. Then lesions were removed and sent for pathologyexamination.Results Use of acetic acid leads to fast acetowhitening reaction of lesions andsurrounding mucosa. 2 groups were distinguished: 1) Loss of acetowhitening(LAW) of lesions occurs earlier than LAW of surrounding mucosa. 2) LAW oflesions occurs later than LAW of surrounding mucosa. Group 1 includes 29(40,8%) polyps, 89,6% of which were non-serrated: 21(72,4%) – tubular adenoma;5(17,2%)- tubular-villous adenoma, one of which had high-grade dysplasia.Only 3(10,3%) polyps were serrated – hyperplastic polyps. Group 2 includes42 (59,2%) polyps, 97,6% of which were serrated: 27(64,3%) – hyperplasticpolyp; 13(30,9%) – sessile serrated adenoma, including one with low-gradedysplasia, 1(2,4%) – traditional serrated adenoma. Only 1(2,4%) polyp was nonserrated– tubular adenoma. This suggests that the LAW of serrated polyps isdelayed compared to the LAW of the surrounding mucosa. On the contrary,LAW of non-serrated polyps occurs faster than LAW of surrounding mucosa.LAW of 4(5,6%) polyps was atypical; the reason for this reaction requires furtherinvestigation.Conclusions Use of acetic acid can be used as a diagnostic method to determinethe serrated polyps during colonoscopy in real time.
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