High Resolution Anoscopy

High Resolution Anoscopy is a procedure which is performed when the anal cytology results in abnormal or even dysplastic cells. Its aim is to discover the HGAIN dysplastic lesions, based on morphological findings (after using acetic acid and Lugol’s solution) and their documentation by the biopsy.

This highly specialized examination is performed only in the US and in a few European countries. In Greece, the last two years, our proctology clinic performs exclusively this procedure. It is similar to colposcopy following the same technique, which is performed by skilled gynecologists for the diagnosis of dysplasia of the external female genitalia.

In our clinic, a high resolution anoscopy is performed in every patient with a possible HPV-infection. Acetic acid is placed into the anal canal for 2-4 minutes and then a proctoscope is introduced into the anus. 

About 6-8 cm of the anus and the perianal skin are examined under magnification and then, the typical morphological alterations of pre-malignant dysplasia caused by HPV are checked (white epithelium, creation of a mosaic, mottle, abnormal blood vessels, etc.). A photographic record of the lesions is taken along with biopsies from the suspicious points (for a complete pathologoanatomical examination). 

If the examination of the biopsies shows a high-grade dysplasia (HGAIN), it has to be correlated to the photographic data. After that, the high resolution anoscopy is repeated and the dysplastic lesions are cauterized under local anesthesia in our proctology clinic.

Anal cancer screening with high resolution anoscopy,  ESCP Meeting- Dublin September 2015, Apostolos Stamatiadis, Ioannis Karaitianos

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