Look, remove, and discard: can narrow-band imaging replace histopathology for small colorectal polyps? It is time to push the button!

摘要

Narrow-band imaging (NBI) is a new endoscopic technology that improves contrast for superficial mucosal capillaries. In conjunction with magnification, this allows appreciation of the mucosal pattern, "pit pattern," and surface microvasculature without the use of dye spray. NBI, therefore, has sometimes been termed "electronic chro-moendoscopy." This feature is available at the push of a button and is inherently quicker, easier, and more appealing to Western endoscopists, who generally have not embraced the use of chromoendoscopy in the colon. A further disincentive to chromoendoscopy-based polyp characterization is the need to learn the Kudo pit pattern classification, which has a long learning curve of more than 200 histolog-ically confirmed polyps , The ability to make an endoscopic diagnosis in vivo during the procedure is appealing for a number of reasons. The majority ofpolyps (90%) removed at colonoscopy are small (6-9 mm) or diminutive (< 5 mm). These lesions very rarely contain carcinoma, 0.9%for adenomas 5 to 10 mm and 0% for adenomas < 5 mm in size in a large pathologic series. Carcinoma has not been reported in diminutive polyps, except in case reports, where the polyps usually have a depressed morphology.