Journal of Gastroenterology

, Volume 44, Issue 8, pp 826–833

The use of indigocarmine spray increases the colonoscopic detection rate of adenomas

  • Kazutomo Togashi
  • David G. Hewett
  • Graham L. Radford-Smith
  • Leo Francis
  • Barbara A. Leggett
  • Mark N. Appleyard
Original Article—Alimentary Tract



It remains controversial whether chromocolonoscopy using indigocarmine increases the detection of colorectal polyps. We aimed to assess the impact of indigocarmine dye spray on the detection rate of adenomas and the feasibility of learning the technique in a Western practice.


400 patients were prospectively allocated into 2 groups; A (n = 200): indigocarmine chromocolonoscopy was performed by a Japanese colonoscopist with expertise in chromoscopy; B (n = 200): initial 100 patients (B-1), a Western colonoscopist with no previous experience of chromoscopy performed conventional colonoscopy, but with at least 10 min observation during colonoscopy withdrawal. In the next 100 patients (B-2), he performed chromocolonoscopy. All polyps found were resected. Regression analysis was used to compare the numbers of polyps detected in groups A, B-1 and B-2, whilst controlling for gender, age, indication and history of colorectal cancer.


There were significant differences in the numbers of neoplastic polyps and flat adenomas between groups A and B-1 as well as between B-1 and B-2, but not between A and B-2. There was no significant difference in numbers of advanced lesions. Chromocolonoscopy (A and B-2) detected more neoplastic polyps of ≤5 mm.


Chromocolonoscopy increases the detection of neoplastic polyps and flat adenomas, particularly diminutive polyps, but does not increase the detection of advanced lesions.


Colonoscopy Chromoendoscopy Indigocarmine Colon polyp 


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Copyright information

© Springer 2009

Authors and Affiliations

  • Kazutomo Togashi
    • 1
    • 3
  • David G. Hewett
    • 1
  • Graham L. Radford-Smith
    • 1
  • Leo Francis
    • 2
  • Barbara A. Leggett
    • 1
  • Mark N. Appleyard
    • 1
  1. 1.Department of Gastroenterology and HepatologyRoyal Brisbane and Women’s HospitalHerstonAustralia
  2. 2.Department of Anatomical PathologyRoyal Brisbane and Women’s HospitalHerstonAustralia
  3. 3.Department of Endoscopy and SurgeryJichi Medical UniversityShimotsukeJapan

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