Background: Pouchitis and dysplasia may affect the reservoir after restorative proctocolectomy. Aims: To assess the suitability of confocal laser endomicroscopy for the in vivo diagnosis of mucosal changes in ileal pouch for ulcerative colitis and familial adenomatous polyposis. Methods: Standard endoscopy and endomicroscopy were performed in 18 pouches. Confocal images were scored for the presence of villous atrophy, inflammation, ulceration, colonic metaplasia and dysplasia. Targeted biopsies were taken. Endomicroscopic and histological findings were compared. Results: At standard endoscopy, the signs of pouchitis were recorded in 7/18 (38.9%) patients. At endomicroscopy, pathological featureswere found in 16/18 (88.9%), villous atrophy in 15/18 (83.3%), inflammation in 13/18 (72.2%), ulceration in 3/18 (16.7%), and colonic metaplasia in 12/18 (67.7%). No dysplasia was observed. At histology, abnormalities were present in 17/18 (94.4%): villous atrophy in 15/18 (83.3%), inflammation in 17/18 (94.4%), ulceration in 6/18 (33.3%), colonic metaplasia in 15/18 (83.3%). Morphological changes of the ileal pouch could be predicted with an accuracy of 94.4% (95% CI: 74.2–99.0). The k-value for intra- and interobserver agreement was 0.93 and 0.78, respectively. Conclusions: Endomicroscopymay be helpful in the evaluation of morphologic changes in ileal pouch. The small size of the population sample requires further studies for the results to be confirmed.

Confocal laser endomicroscopy for the detection of mucosal changes in ileal pouch after restorative proctocolectomy / C. Trovato, A. Sonzogni, G. Fiori, D. Ravizza, D. Tamayo, F. Botti, A. Carrara, A. Zefelippo, E. Contessini Avesani, C. Crosta. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 41:8(2009 Aug), pp. 578-585.

Confocal laser endomicroscopy for the detection of mucosal changes in ileal pouch after restorative proctocolectomy

F. Botti;A. Carrara;A. Zefelippo;E. Contessini Avesani
Penultimo
;
2009

Abstract

Background: Pouchitis and dysplasia may affect the reservoir after restorative proctocolectomy. Aims: To assess the suitability of confocal laser endomicroscopy for the in vivo diagnosis of mucosal changes in ileal pouch for ulcerative colitis and familial adenomatous polyposis. Methods: Standard endoscopy and endomicroscopy were performed in 18 pouches. Confocal images were scored for the presence of villous atrophy, inflammation, ulceration, colonic metaplasia and dysplasia. Targeted biopsies were taken. Endomicroscopic and histological findings were compared. Results: At standard endoscopy, the signs of pouchitis were recorded in 7/18 (38.9%) patients. At endomicroscopy, pathological featureswere found in 16/18 (88.9%), villous atrophy in 15/18 (83.3%), inflammation in 13/18 (72.2%), ulceration in 3/18 (16.7%), and colonic metaplasia in 12/18 (67.7%). No dysplasia was observed. At histology, abnormalities were present in 17/18 (94.4%): villous atrophy in 15/18 (83.3%), inflammation in 17/18 (94.4%), ulceration in 6/18 (33.3%), colonic metaplasia in 15/18 (83.3%). Morphological changes of the ileal pouch could be predicted with an accuracy of 94.4% (95% CI: 74.2–99.0). The k-value for intra- and interobserver agreement was 0.93 and 0.78, respectively. Conclusions: Endomicroscopymay be helpful in the evaluation of morphologic changes in ileal pouch. The small size of the population sample requires further studies for the results to be confirmed.
Confocal laser endomicroscopy; Familial adenomatous polyposis; Ileal pouch; Pouchitis; Ulcerative colitis
Settore MED/18 - Chirurgia Generale
ago-2009
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/63987
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