Adenoma detection by Endocuff-assisted versus standard colonoscopy in routine practice: a cluster-randomised crossover trial

Abstract

ObjectiveEndocuff Vision (ECV) is the second generation of a device designed to improve polyp detection. The aim of this study was to evaluate its impact on adenoma detection rate (ADR) in routine colonoscopy.DesignThis cluster-randomised crossover trial compared Endocuff-assisted (ECV+) with standard (ECV-) colonoscopy. Two teams of 11 endoscopists each with prior ECV experience, balanced in terms of basal ADR, gender and case volume were compared. In randomised fashion, the teams started with ECV+ or ECV- and switched group after inclusion of half of the cases. The main outcome criterion was ADR difference between ECV+ and ECV-. Subgroup analysis was done for physicians with low and high ADR (< or ≥ 25%).ResultsDuring two periods of 20 and 21 weeks, respectively, the 22 endoscopists included 2058 patients (1032 ECV- vs 1026 ECV+, both groups being comparable). Overall ADR for both groups taken together was higher with ECV (39.2%) than without (29.4%; p<0.001) irrespective of the sequence of use (ECV+ or ECV- first), but mostly in adenomas <1 cm. In the physician subgroup analysis, only high detectors showed a significant ADR increase (from 31% to 41%, p<0.001), while the increase in the low detectors was not significant (from 24% to 30%, p=0.11). ECV had a positive impact in all colonic locations, except for the rectum. No ECV- related complication was reported.ConclusionWe observed a significant ADR difference of approximately 10% by the use of ECV. By subgroup analysis, this increase was significant only in physicians classified as high detectors.Trial registration numberClinicalTrials.gov (NCT03344055).

Efficacy of Endocuff Vision compared to first-generation Endocuff in adenoma detection rate and polyp detection rate in high-definition colonoscopy: a systematic review and network meta-analysis

“…The MAP was not clinically and statistically different for ECV group when compared to HD colonoscopy (MD: 0.14, 95 % CI–0.01–0.28, p = 0.06, I 2 = 53.1 %) ( Supplementary Fig. 1d ) 15 23 28 35 .…”

“…Twelve RCTS were included after rigorous screening of abstracts and full texts with a total of 8638 patients (4285 in HD group, 4353 in Endocuff group) ( Fig. 1 ) 15 25 26 27 28 29 30 31 32 33 34 35 . All studies were published after 2014.…”

“…The groups were similar in terms of age range (55.7–68 vs 55.1–68), male gender (52.9 % vs 52.1 %) and screening/surveillance indication (60.8 % vs 60.7 %). Of the Endocuff group, 2627 patients (6 studies) underwent ECV colonoscopy 14 25 29 30 33 35 and 1726 patients (6 studies) underwent ECU colonoscopy 26 27 28 31 32 34 ( Table 1 ). The outcomes for individual studies are summarized in Table 2 .…”

Endocuff-Assisted Colonoscopy Does Not increase the Sessile Serrated Lesion Detection Rate – A Randomized Controlled Trial

“…Recently, a debate has started regarding whether the effectiveness of EV differs depending on the individual endoscopist. Some data suggested that "high detectors" obtained no additional bene t from using the Endocuff [39]; however, in a cluster randomized crossover trial performed in 2020, a subanalysis suggested that "high detectors" (de ned as those with an ADR>25%) had a signi cantly higher ADR when using EV (mean difference 10.3%, p=0.001), while low detectors had a nonsigni cant mean difference (6.7%, p=0.11) [40]. Our study did not allow us to explore this hypothesis due to the sample size and the fact that all endoscopists had ADRs above 40%, which may explain our results.…”

Endocuff Vision improves adenoma detection rate in a large screening-related cohort

“…Distal attachment ▶ ▶ Table 2 Crude and adjusted odds ratios for adenoma and sessile serrated adenoma detection by selected variables. devices are simple to use [12][13][14], and ECV in particular is efficacious in improving ADR [20][21][22][23]. No large "real-world" studies have assessed the effectiveness of ECV.…”