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

Research output: Contribution to journalArticlepeer-review

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 features were 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: Endomicroscopy may 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.

Original languageEnglish
Pages (from-to)578-585
Number of pages8
JournalDigestive and Liver Disease
Volume41
Issue number8
DOIs
Publication statusPublished - Aug 2009

Keywords

  • Confocal laser endomicroscopy
  • Familial adenomatous polyposis
  • Ileal pouch
  • Pouchitis
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Fingerprint

Dive into the research topics of 'Confocal laser endomicroscopy for the detection of mucosal changes in ileal pouch after restorative proctocolectomy'. Together they form a unique fingerprint.

Cite this