SURVEILLANCE WITH CHROMOENDOSCOPY TO DETECT NEW DYSPLASIA IN INFLAMMATORY BOWEL DISEASE

Aims We aimed to assess our endoscopic results from follow-up chromoendoscopy in Inflammatory Bowel Disease (IBD) patients with previous diagnose of dysplasia.

Methods Retrospective data collection from IBD patients who have had dysplastic lesions in screening chromoendoscopy, performed in our hospital from January´13 to November´18.

Demographic and clinical data were collected, as well as endoscopic findings in basal chromoendoscopy and in the first follow-up.

Results 320 chromoendoscopies were performed and 41 patients show dysplastic lesions. 12 (30%) had already had dysplasia in previous colonoscopies.

Tab. 1 Patients basal characteristics (N = 41)

Male	75,5%
Age	58 (23.8–77.4)
Type of IBD (Ulcerative Colitis)	84%
Median years of IBD diagnosis	16
Familiar history of CRC	26,7%

In the initial chromoendoscopy, an average of 2.89 dysplastic lesions with an average size of 8 mm was detected and 76.9% were flat lesions (0-IIa/0-IIb Paris). 80% were tubular adenomas low grade dysplasia (LGD), 2 cases of high grade dysplasia (HGD) and one adenocarcinoma.

25 follow-up chromoendoscopes have been performed and new dysplasic lesions were found in 39% (average of 3.25 lesions, < 10 mm). 50% were tubular adenomas LGD and 12.5% serrated adenomas LGD.

Our analysis shows that patients with 0-IIa lesions in baseline chromoendoscopy have more frequent dysplastic lesions afterwards compared to those with 0Is lesions (78.6%vs0%, p = 0.035). Patients whose Boston was < 8 in baseline chromoendoscopy have a greater number of lesions in the next one (16vs8; p = 0.005).

Conclusions Surveillance with chromoendoscopy in IBD patients with previous dysplastic lesions detects new dysplasia in 30% and LGD is the most frequent histology. In our sample, finding higher number of lesions, 0-IIa lesions or worse bowel cleaning in the first chromoendoscopy predicts having a higher number of lesions on the follow-up.