Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 39: Can We Follow Flat Low-Grade Dysplasia? Is Any Dysplasia Really Flat Or Just A Spectrum Of Depth And Size? (continued)

Arun Swaminath, MD; Thomas Ullman, MD

Precisely when to recommend colectomy has remained a topic of concern since the institution of colonoscopic dysplasia surveillance in inflammatory bowel disease (IBD). Because patients with high-grade dysplasia (HGD) carry an approximately 50% chance of already harboring colorectal cancer, few question the wisdom of offering a colectomy to these patients. In addition, the complete endoscopic resection of polypoid dysplastic lesions has gained near-universal acceptance as an alternative to colectomy. However, flat low-grade dysplasia (LGD) presents more of a challenge to patients and…