Peer-review started: October 29, 2018
First decision: November 27, 2018
Revised: December 19, 2018
Accepted: December 21, 2018
Article in press: December 21, 2018
Published online: January 6, 2019
Processing time: 69 Days and 6.8 Hours
Endoscopy has become increasingly fundamental in the management of patients with inflammatory bowel disease (IBD). It is required for diagnosis, assessment of therapeutic response, postoperative follow up and in the surveillance of dysplasia. With rapid advances in technology, including high definition colonoscopy and chromoendoscopy, questions have arisen regarding the most appropriate surveillance and management strategies of colorectal neoplasia in IBD. We aim to review current surveillance strategies, explore the utility of new technologies, and examine the role of endoscopic resection, with the aim of clarifying these questions.
Core tip: With the use of new generation, high definition endoscopy, most dysplasia is visually identifiable and hence targeted biopsies are advised. Random biopsies may be utilised in patients with a personal history of neoplasia, primary sclerosis cholangitis, and a tubular colon. Any lesion deemed to be endoscopically resectable should be referred to centres with expertise to do so whilst invisible dysplasia should prompt consideration towards a colectomy.