Is Chromoendoscopy with Indigocarmine Useful for Detecting Additional Lesions in Patients Referred for Endoscopic Resection of Gastric Adenoma or Cancer?

Park, Jung Ho; Lee, Jun Haeng; Lim, Yun Jeong; Rhee, Poong Lyul; Kim, Jae J; Paik, Seung Woon; Rhee, Jong Chul; Park, Cheol Keun

Abstract

BACKGROUND/AIMS
Endoscopic mucosal resection (EMR) is frequently performed for the treatment of gastric adenoma or early gastric cancer. These lesions are commonly associated with atrophic gastritis and synchronous lesions are not uncommon. The aim of this study was to evaluate the usefulness of chromoendoscopy with indigocarmine in detecting additional lesions patients referred for EMR.
METHODS
Chromoendoscopy was performed in 51 patients (M : F=41 : 10, mean age= 60 year). After a careful examination, the stomach was stained with a 30 mL of indigocarmine (0.2%) with a spraying catheter. The changes in size of the lesions and the possibility of finding additional lesions were compared between before and after spraying dye.
RESULTS
Before dye-spraying, six additional lesions were found. On the other hand, before the chromoendoscopy with indigocarmine. And among these, microscopic examination confirmed the presence of adenomas for additional three lesions. After spraying indigocarmine, eight additional lesions were found suspicious for adenoma, after the dye spraying. However, there was no neoplastic lesions histopathologically. With dye-spraying, the lesions looked bigger in four cases. And the three lesions among them showed similar size compared to the patholgic report.
CONCLUSIONS
A conventional gastroscopic examination was enough to find additional adenoma or cancer, whereas chromoendoscopy was not so helpful in detecting additional lesions. In addition, because indigocarmine dye-spraying could outline mucosal elevations, chromoendoscopy was benefical in accurately measuring the size of the lesion.