ELMAS KASAP, Müjdat ZEYBEL, Hafize KURT, Semin AYHAN, Hakan YÜCEYAR

Ülseratif kolit olgularında standart konvansiyonel endoskopi mi, dar bant yöntemi ile yapılan endoskopi mi şiddet belirlemede etkindir?

Amaç: Bu çalışmada amacımız ülseratif kolit olgularında endoskopik değerlendirmede, standart yöntem ve dar bant görüntüleme arasında fark olup olmadığı ve her iki tekniğin histopatolojik bulgular ile karşılaştırılmasıdır. Gereç ve Yöntem: Çalışmaya ülseratif kolit tanısıyla takip ve tedavi edilen ve kolonoskopi uygulanan 30 hasta (16 kadın, 14 erkek) prospektif olarak dahil edilmiştir. Tüm olgulara kolonoskopi uygulanmış ve biyopsi alınmıştır. Bulgular: Dar bant görüntülemede standart endoskopiye göre normal endoskopik bulgunun anlamlı olarak daha az görüldüğü bulunmuştur (p=0.015). Vasküler paternin kaybolması dar bant görüntülemede standart endoskopiye göre daha anlamlı olarak değerlendirildiği görülmüştür (p=0.04). Standart endoskopide normal olarak değerlendirilen fakat histopatolojik olarak normal çıkmayan tüm vakalarda histopatolojik olarak hafif ve orta şiddette inflamasyon tespit edilmiştir. Hafif-orta şiddette inflamasyon ise histopatolojik olarak standart endoskopiye oranla anlamlı olarak yüksek çıkmıştır (p=0.015). Sonuç: Ülseratif kolit olgularında özellikle düşük hastalık aktivitesi olan hastaların endoskopik değerlendirmesinde dar bant görüntüleme tekniği standart konvansiyonel endoskopiye göre daha değerli olmasına rağmen dar bant görüntüleme yöntemi ile erken malignite tespitinde çok merkezli ve daha uzun süreli hastalığa (10 yıl ve üzeri) sahip olan hastalar ile değerlendirme yapılmasının uygun olacağı kanaatindeyiz.

Anahtar Kelimeler:

Ülseratif kolit, standart endoskopi, dar bant yöntemli endoskopi

Which method is more useful for detecting ulcerative colitis severity? Standard white light or narrow band imaging endoscopy?

Background and Aims: In this study, we aimed to show the differences in determining endoscopic severity in ulcerative colitis between standard white light endoscopy and narrow band imaging by comparing results with the histopathological examination. Materials and Methods: A total of 30 (16 female, 14 male) ulcerative colitis subjects were recruited prospectively. Colonoscopy and biopsy were applied in all subjects. Results: Narrow band imaging was more sensitive than standard white light endoscopy in distinguishing normal endoscopic findings (p=0.0015). Evaluation of the disappearance of vascular pattern was more sensitive with narrow band imaging than with standard white endoscopy (p=0.04). The patients evaluated as normal with standard endoscopy but as not normal with histopathological diagnosis had histopathologically mild to moderate inflammation. Mild to moderate inflammation was more prevalent in histopathological findings than in standard white endoscopy (p=0.015). Conclusions: Narrow band imaging was more sensitive for evaluating the disappearance of vascular pattern than standard endoscopy evaluation in patients with low disease activity. We think this is a precursor study for multi-center studies regarding detection of malignancy in ulcerative colitis with long-term disease.

Keywords:

Ulcerative colitis, standard white light endoscopy, narrowband imaging endoscopy,

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