SAGES TAVAC Safety and Efficacy Analysis Confocal Laser Endomicroscopy

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2020 May 15

PMID 32405892

Citations 9

Authors

Mazen R Al-Mansour

Antonio Caycedo-Marulanda

Brian R Davis

Abdulrahim Alawashez

Salvatore Docimo

Alia Qureshi

Shawn Tsuda

Affiliations

Soon will be listed here.

Abstract

Background: Confocal laser endomicroscopy (CLE) is a novel endoscopic adjunct that allows real-time in vivo histological examination of mucosal surfaces. By using intravenous or topical fluorescent agents, CLE highlights certain mucosal elements that facilitate an optical biopsy in real time. CLE technology has been used in different organ systems including the gastrointestinal tract. There has been numerous studies evaluating this technology in gastrointestinal endoscopy, our aim was to evaluate the safety, value, and efficacy of this technology in the gastrointestinal tract.

Methods: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Technology and Value Assessment Committee (TAVAC) performed a PubMed/Medline database search of clinical studies involving CLE in May of 2018. The literature search used combinations of the keywords: confocal laser endomicroscopy, pCLE, Cellvizio, in vivo microscopy, optical histology, advanced endoscopic imaging, and optical diagnosis. Bibliographies of key references were searched for relevant studies not covered by the PubMed search. Case reports and small case series were excluded. The manufacturer's website was also used to identify key references. The United States Food and Drug Administration (U.S. FDA) Manufacturer And User facility and Device Experience (MAUDE) database was searched for reports regarding the device malfunction or injuries.

Results: The technology offers an excellent safety profile with rare adverse events related to the use of fluorescent agents. It has been shown to increase the detection of dysplastic Barrett's esophagus, gastric intraepithelial neoplasia/early gastric cancer, and dysplasia associated with inflammatory bowel disease when compared to standard screening protocols. It also aids in the differentiation and classification of colorectal polyps, indeterminate biliary strictures, and pancreatic cystic lesions.

Conclusions: CLE has an excellent safety profile. CLE can increase the diagnostic accuracy in a number of gastrointestinal pathologies.

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Advances in Pediatric Diagnostic Endoscopy: A State-of-the-Art Review.

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Impaired Intestinal Permeability Assessed by Confocal Laser Endomicroscopy-A New Potential Therapeutic Target in Inflammatory Bowel Disease.

Chiriac S, Sfarti C, Minea H, Stanciu C, Cojocariu C, Singeap A Diagnostics (Basel). 2023; 13(7).

PMID: 37046447 PMC: 10093200. DOI: 10.3390/diagnostics13071230.

Confocal laser endomicroscope with distal MEMS scanner for real-time histopathology.

Lee M, Li G, Li H, Duan X, Birla M, Chang T Sci Rep. 2022; 12(1):20155.

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