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Dig Dis Sci. 2018 Mar;63(3):775-780. doi: 10.1007/s10620-018-4918-6. Epub 2018 Jan 30.

Clinical Effectiveness of Submucosal Injection with Indigo Carmine Mixed Solution for Colon Endoscopic Mucosal Resection.

Author information

1
Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 23-20 Bongmyung-Dong, Cheonan, Choongnam, 330-721, Republic of Korea.
2
Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 23-20 Bongmyung-Dong, Cheonan, Choongnam, 330-721, Republic of Korea. yoonho7575@naver.com.
3
Department of Pathology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.

Abstract

BACKGROUND/AIMS:

Submucosal injection with indigo carmine mixed solution can improve the delineation of colorectal neoplasia during endoscopic mucosal resection (EMR). Thus, the aim of this study was to evaluate the efficacy of submucosal injection with indigo carmine mixed solution during EMR of colorectal neoplasia.

METHODS:

This was a prospective, randomized, controlled study of a total of 212 neoplastic colon polyps (5-20 mm) subjected to EMR in a single tertiary university hospital. The patients were randomized into two groups according to whether or not indigo carmine mixed solution was used, and the complete resection rate (CRR) after EMR was evaluated.

RESULTS:

A total of 212 neoplastic polyps (normal saline group, 115; indigo carmine group, 97) were successfully removed by EMR. There was no significant difference in the CRR (92.8 vs. 89.6%, p = 0.414) or macroscopic delineation (86.0 vs. 93.8%, p = 0.118) between the two groups. In a separate analysis of sessile serrated adenomas/polyps (SSAs/Ps), macroscopic delineation was better in the indigo carmine group than the normal saline group (87.5 vs. 53.8%), albeit not significantly (p = 0.103). In univariate analyses, the CRR was significantly related to polyp location, polyp morphology, macroscopic delineation, and pathologic findings. In a multiple logistic regression analysis, macroscopic delineation (odds ratio (OR), 7.616, p = 0.001) and polyp pathology (OR, 8.621; p < 0.001) were significantly associated with the CRR.

CONCLUSIONS:

Submucosal injection with indigo carmine mixed solution did not improve the CRR or macroscopic delineation of EMR of colorectal neoplasias.

KEYWORDS:

Colon endoscopic mucosal resection; Complete resection rate; Indigo carmine; Sessile serrated adenomas/polyps; Submucosal injection

PMID:
29383606
DOI:
10.1007/s10620-018-4918-6
[Indexed for MEDLINE]

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