Safety of surveillance colonoscopy in long-standing ulcerative colitis.

OBJECTIVE

Because of the increased risk of colorectal cancer in patients with long-standing ulcerative colitis, colonoscopic surveillance for the detection of dysplasia is currently recommended as a method of identifying high-risk patients. However, the hazard of colonoscopy with multiple biopsies in such patients is not well known. Our objective was to assess the safety of surveillance colonoscopy in patients with long-standing ulcerative colitis.

METHODS

To accomplish our objective, we conducted a retrospective analysis of results and follow-up of surveillance colonoscopies.

RESULTS

A total of 6,727 biopsies were obtained during 384 colonoscopies, with a median of 17 biopsies per colonoscopy. Nineteen studies were performed in a setting of underlying stricture. A single complication of a silent perforation occurred in a patient with an underlying stricture. No instances of bleeding, infection, respiratory distress, myocardial infarction, or death resulted from the procedure.

CONCLUSION

Our findings suggest that surveillance colonoscopy with multiple biopsies is a relatively safe procedure. Given increasing evidence of the survival benefit derived from the procedure, we believe these results render further support for the current practice of surveillance colonoscopy in patients with ulcerative colitis.