Last updated on April 2018

Detection and Characterization of Sessile Serrated Lesions (SSL) of the Right Colon

Brief description of study

There are a few studies regarding Sessile Serrated Lesions (SSL). They are recently identified as precancerous lesions. Yet, digestive tract serrated lesions would be part of a new colic carcinogenesis way : the serrated tumor way. Evolution from polyp to cancer would be faster than through the usual adenoma to cancer way. It would be then responsible of a lot of "missed" lesions or interval cancer. The missed SSL rate is estimated at between 27% and 59%.

Current diagnosis methods show weakness to identify those SSL. In order to improve their detection, the investigators dispose of several coloration techniques. Indigo carmine chromoendoscopy enhance neoplastic lesion detection as part of the hereditary rectal carcinoma screening. NBI electronic coloration, which is faster and easier has not shown any efficacy on the adenoma detection rate, except for patients with Lynch syndrome.

The objective is to better describe the SSL endoscopic semiology (detection and characterization) and to establish standards for the endoscopic techniques in order to improve the colonoscopy diagnosis quality. The investigators propose to evaluate 2 fundamental endoscopic techniques (Narrow Band Imaging (NBI) and indigo carmine), widely used for other indications, in comparison with the White Light technique (WLI).

Therefore, the investigators propose a prospective, observational, multicentric cohort study in order to 1) define SSL endoscopic various aspects 2) establish which technique (white light, Narrow Band Imaging, indigo carmine chromoendoscopy) is the best to diagnose SSL, namely detection and characterization 3) evaluate the multifocal dimension rate for those lesions at ascending colon level.

The diagnosis impact is immediate, and could allow to consider an update for boh endoscopic NICE and Kudo Pit Pattern classification, and good practice guidances for colonoscopic diagnosis. Better SSL detectability thus their systematic resection could have a long term effect in reducing both colon cancer rate and interval cancer

Clinical Study Identifier: NCT02861885

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H pital Estaing, CHU Clermont Ferrand, NHE Service d'H pato-gastroent rologie, 1 place Lucie Aubrac
Clermont-ferrand, France
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Jean-Christophe SOUQUET, Pr

Hospices Civils de Lyon, H pital de la Croix Rousse, Service d'h pato-gastroent rologie, 103 Grande-Rue de la Croix Rousse
LYON cedex 04, France
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Centre Hospitalier Saint JOSEPH Saint Luc, Service d'h pato-gastroent rologie, 20 quai Claude Bernard
Lyon, France
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Hospices Civils de Lyon, H pital E Herriot, Service d'h patogastroent rologie, 5 place d'Arsonval
Lyon, France
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Hospices Civils de Lyon, H pital Lyon Sud, Service d'h pato-gastroent rologie, Chemin Grand Revoyet
Pierre Benite, France
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Centre Hospitalier Villefranche sur Sa ne, Service d'H pato-gastroent rologie, Plateux d'Ouilly Gleize
Villefranche Sur Saone, France
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