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Use of Confocal Laser Endomicroscopy to Assess the Adequacy of Endoscopic Treatment of Gastrointestinal Neoplasia: A Systematic Review and Meta-Analysis

Ypsilantis, Efthymios MSc, MPhil, MRCS; Pissas, Dimitrios MD, PhD; Papagrigoriadis, Savvas MD, MSc, FRCS; Haji, Amyn MA, MBBChir, MSc, MD, FRCS

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: February 2015 - Volume 25 - Issue 1 - p 1–5
doi: 10.1097/SLE.0000000000000072
Review Articles
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Evaluation of the adequacy of endoscopic mucosal resection (EMR) of gastrointestinal lesions remains challenging by use of conventional endoscopy. Confocal laser endomicroscopy (CLE) is a novel imaging technique, designed to provide in vivo histology, and facilitate diagnosis with real-time intervention. We undertook a systematic review of the available literature, exploring the role of CLE in assuring completeness of EMR of gastrointestinal lesions. The number of pertinent studies is very limited, including only 1 randomized controlled study and 2 prospective comparative case series. Per-lesion meta-analysis showed that the sensitivity of CLE for detection of residual neoplasia was 91% (95% confidence interval, 82.5%-96%) with specificity of 69% (95% confidence interval, 61%-77%), with significant heterogeneity noted in all outcomes. In conclusion, the evidence underpinning the usefulness of CLE in ensuring adequate EMR of gastrointestinal neoplasia is currently very weak, with limited promising results related to gastric and colorectal polyp resections.

Department of Colorectal Surgery and Endoscopy, King’s College Hospital, Denmark Hill, London, UK

The authors declare no conflicts of interest.

Reprints: Efthymios Ypsilantis, MSc, MPhil, MRCS, Department of Colorectal Surgery and Endoscopy, King’s College Hospital, Denmark Hill, London SE5 9RS, UK (e-mail: makypsi@yahoo.com).

Received March 31, 2014

Accepted April 15, 2014

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