RASTREAMENTO DE LESÕES NEOPLÁSICAS EM CÓLON DIREITO POR COLONOSCOPIA: UM ESTUDO RANDOMIZADO E CONTROLADO DE COLONOSCOPIA CONVENCIONAL VERSUS CROMOSCOPIA COM ÍNDIGO CARMIM E DIGITAL

The study of colorectal neoplastic lesions, particularly adenomatous ones, is relevant due to their association with colorectal carcinoma (CRC), the fourth leading cause of cancer in Brazil. Screening aims to detect premalignant lesions or early-stage cancer, reducing disease progression through endoscopic resection. This research evaluated the detection rate of colorectal neoplastic lesions in conventional colonoscopy compared to digital chromoendoscopy methods (FICE) and indigo carmine in the right colon. A total of 309 patients underwent screening between September 2017 and May 2018, divided into three randomized groups: indigo carmine, FICE, and white light. Twenty-eight patients were excluded due to criteria such as inadequate bowel preparation or a history of colorectal surgeries. The right colon (cecum, ascending colon, and hepatic flexure) was evaluated twice: initially with white light and subsequently according to the designated modality. The patients’ mean age was 55.7 years, with no significant differences between sexes. Polyp detection increased after reevaluation in all groups. The indigo carmine group showed a relative risk of detection 3.54 times higher than the FICE group and 5.19 times higher than the white light group (p<0.0001). The average examination time was highest in the indigo carmine group (22.4 minutes), followed by FICE (20.7 minutes) and white light (20.5 minutes). Of the 56 resected lesions, 45 (80.3%) were located in the ascending colon, and 28 (50%) were diagnosed as adenomas. It is concluded that chromoendoscopy with indigo carmine in the right colon provides a higher polyp detection rate, justifying its use in clinical practice despite the longer examination time required for this technique.