Effect of Endocuff-assisted colonoscopy on adenoma detection rate: meta-analysis of randomized controlled trials

Williet, Nicolas; Tournier, Quentin; Vernet, Chloé; Dumas, Olivier; Rinaldi, Leslie; Roblin, Xavier; Phélip, Jean-Marc; Pioche, Mathieu

doi:10.1055/a-0577-3500

Cited by 65 publications

(72 citation statements)

References 32 publications

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“…Williet et al . reported in their meta‐analysis that the ADR was significantly higher in the EAC group than in the SC group, especially for operators with low‐to‐moderate ADRs (< 35%); however, no benefit was achieved for operators with high ADRs (> 45%) . In our study, the ADR in both the EAC and TAC groups was > 50%.…”

Section: Discussioncontrasting

confidence: 49%

“…A meta‐analysis of EAC versus SC including four randomized controlled trials, four retrospective cohort studies, and one prospective observational study showed that the ADR was significantly higher in the EAC group than in the SC group . Another recent meta‐analysis of EAC versus SC including 12 randomized controlled trials showed that the ADR and polyp detection rate were significantly higher in the EAC group than in the SC group, and the MAP tended to be higher with EAC . In this study, it was assumed that the ADR in the EAC group may be superior to that in the TAC group; however, the ADR and MAP in the EAC group were not superior to those in the TAC group.…”

Section: Discussionmentioning

confidence: 88%

“…On the other hand, a meta‐analysis by Williet et al . reported that adverse events related to Endocuff were rare and exclusively mild mucosal erosion …”

Section: Discussionmentioning

confidence: 99%

“…It flattens the mucosal folds during withdrawal and keeps the tip of the colonoscope steady during interventions. Previous meta‐analysis studies have demonstrated that Endocuff‐assisted colonoscopy (EAC) improves polyp or adenoma detection relative to SC . Rex et al .…”

Section: Introductionmentioning

confidence: 99%

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Randomized control trial of adenoma detection rate in Endocuff‐assisted colonoscopy versus transparent hood‐assisted colonoscopy

Imaeda

Yamaoka

Ohgo

et al. 2019

J of Gastro and Hepatol

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Background and Aim Transparent hood‐assisted colonoscopy (TAC) has been reported to improve the cecal insertion rate and adenoma detection rate (ADR). An endoscopic cap (Endocuff) with two rows of soft wings was recently developed to improve ADR, by flattening the mucosal folds during withdrawal. This randomized prospective control study aimed to compare ADR between Endocuff‐assisted colonoscopy (EAC) and TAC. Methods A total of 513 patients undergoing colon adenoma screening were included. EAC was performed in 256 patients and TAC in 260 patients. Cecal intubation rate, cecal intubation time, ADR, and mean adenoma number per patient (MAP) were investigated in both groups (clinical trial registration: UMIN000016278). Results We excluded six patients in the EAC group and two patients in the TAC group because of colonic stenosis due to colonic adenocarcinomas. Finally, 250 patients (151 men/99 women, median age 62.1 years) were assigned to EAC and 258 patients (165 men/93 women, median age 64.3 years) were assigned to TAC. There were no significant differences in cecal intubation rate, intubation time, withdrawal time, and cleanliness score between groups. The ADR was 50.8% in EAC and 52.7% in TAC, with no significant difference (P = 0.666). The MAP was 1.35 in EAC and 1.20 in TAC, with no significant difference (P = 0.126). However, The MAP of diminutive adenomas (< 5 mm) tended to be higher in EAC than in TAC (P = 0.077). There was no significant difference in MAP in each segment between groups. Conclusions Endocuff‐assisted colonoscopy might be equivalent to TAC in cecal intubation time, ADR, and MAP.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 88%

“…On the other hand, a meta‐analysis by Williet et al . reported that adverse events related to Endocuff were rare and exclusively mild mucosal erosion …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Randomized control trial of adenoma detection rate in Endocuff‐assisted colonoscopy versus transparent hood‐assisted colonoscopy

Imaeda

Yamaoka

Ohgo

et al. 2019

J of Gastro and Hepatol

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“…Three meta‐analyses have been performed to confirm the effect of EndoCuff . Fewer studies were included in the early meta‐analysis, and most of these articles were of low quality.…”

Section: Introductionmentioning

confidence: 99%

EndoCuff‐assisted colonoscopy could improve adenoma detection rate: A meta‐analysis of randomized controlled trials

Jian

Feng

Zhang

et al. 2019

J of Digest Diseases

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Objective This meta‐analysis aimed to evaluate whether EndoCuff‐assisted colonoscopy (EAC) could improve adenoma detection rate (ADR) compared with standard colonoscopy (SC). Methods PubMed, EMBASE, Scopus, Cochrane Library, and Google Scholar databases were searched for articles published up to March 2019. All pure randomized controlled trials comparing ADR between EAC and SC groups were included. Dichotomous data were pooled to obtain the odds ratio with a 95% confidence interval (CI), whereas continuous data were pooled using a mean difference with 95% CI. Review Manager Version 5.3 was used for data analysis. Results Thirteen randomized controlled trials consisting of 9038 patients (EAC: 4574; SC: 4464) were included. The EAC group showed significant superiority over the SC group in ADR (odds ratio 1.37, 95% CI 1.15–1.62). However, there were no differences between the EAC and SC groups in adverse events, cecal intubation rate, and cecal intubation time. Conclusions EAC could significantly improve ADR without increasing adverse events, especially for operators with low ADRs. In addition, no significant difference was observed in cecal intubation time and cecal intubation rate between EAC and SC.

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Detection of colorectal lesions during colonoscopy

2021

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Owing to its high mortality rate, the prevention of colorectal cancer is of particular importance. The resection of colorectal polyps is reported to drastically reduce colorectal cancer mortality, and examination by endoscopists who had a high adenoma detection rate was found to lower the risk of colorectal cancer, highlighting the importance of identifying lesions. Various devices, imaging techniques, and diagnostic tools aimed at reducing the rate of missed lesions have therefore been developed to improve detection. The distal attachments and devices for improving the endoscopic view angle are intended to help avoid missing blind spots such as folds and flexures in the colon, whereas the imaging techniques represented by image‐enhanced endoscopy contribute to improving lesion visibility. Recent advances in artificial intelligence‐supported detection systems are expected to supplement an endoscopist's eye through the instant diagnosis of the lesions displayed on the monitor. In this review, we provide an outline of each tool and assess its impact on the reduction in the incidence of missed colorectal polyps by summarizing previous clinical research and meta‐analyses. Although useful, the many devices, image‐enhanced endoscopy, and artificial intelligence tools exhibited various limitations. Integrating these tools can improve their shortcomings. Combining artificial intelligence‐based diagnoses with wide‐angle image‐enhanced endoscopy may be particularly useful. Thus, we hope that such tools will be available in the near future.

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Effect of Endocuff-assisted colonoscopy on adenoma detection rate: meta-analysis of randomized controlled trials

Abstract: With moderate-quality evidence, this study showed an improvement in ADR with EAC without major adverse events, especially for operators with low-to-moderate ADRs.

Cited by 65 publications

References 32 publications

Randomized control trial of adenoma detection rate in Endocuff‐assisted colonoscopy versus transparent hood‐assisted colonoscopy

Randomized control trial of adenoma detection rate in Endocuff‐assisted colonoscopy versus transparent hood‐assisted colonoscopy

EndoCuff‐assisted colonoscopy could improve adenoma detection rate: A meta‐analysis of randomized controlled trials

Detection of colorectal lesions during colonoscopy

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