High-definition colonoscopy versus Endocuff versus EndoRings versus full-spectrum endoscopy for adenoma detection at colonoscopy: a multicenter randomized trial

Rex, Douglas K.; Repici, Alessandro; Gross, Seth A.; Hassan, Cesare; Ponugoti, Prasanna L.; Garcia, Jonathan R.; Broadley, Heather M.; Thygesen, Jack C.; Sullivan, Andrew W.; Tippins, William W.; Main, Samuel A.; Eckert, George J.; Vemulapalli, Krishna C.

doi:10.1016/j.gie.2018.02.043

Cited by 114 publications

(136 citation statements)

References 23 publications

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“…Colonic adenomas may be missed when they are hidden behind the colonic folds or flexures. The exposure of the mucosa behind folds, adequate distension, a clean colon, and sufficient inspection time to visually observe the exposed mucosa is effective for detection of colonic adenomas . High‐definition colonoscopes aid in detection and are now widely considered fundamental to detection and effective treatments .…”

Section: Introductionmentioning

confidence: 99%

“…High‐definition colonoscopes aid in detection and are now widely considered fundamental to detection and effective treatments . Adjunctive devices and techniques have also been widely investigated, including chromoendoscopy and image‐enhanced endoscopy; mucosal exposure devices such as transparent hood, Endocuff, EndoRings,and the Third Eye Retroscope; and ultra‐wide‐angle endoscopes such as full‐spectrum endoscopy and the extra‐wide‐view colonoscope …”

Section: Introductionmentioning

confidence: 99%

“…Rex et al . reported that mean adenoma number per patient (MAP) with Endocuff, EndoRings, and SC were all higher than FUSE and that MAP for Endocuff was higher than SC; moreover, the ADR with Endocuff was superior to SC, EndoRings, and FUSE . Mean cecal insertion time with Endocuff is shorter than with both FUSE and EndoRings.…”

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: Introductionmentioning

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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“…Examples are back to back colonoscopy, retroflexion, transparent cap-assisted colonoscopy, and special devices such as the EndoCuff (Arc Medical Ltd., Leeds, UK) and the EndoRings (Endo-Aid, Caesarea, Israel) [23][24][25]. All of these improvements using WLI observation are influenced by the settings of structure enhancement and CE settings.…”

Section: Discussionmentioning

confidence: 99%

High Enhancement Settings for White Light Observation Improves Colorectal Polyp Visibility in Color Difference Value and an Endoscopist’s Visibility

et al. 2018

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Background/Aims: Settings of structure and color enhancement (CE) change view of white light imaging and a preset low enhancement setting is used regularly. The aim of this study was to investigate whether higher enhancement settings increased colorectal lesions’ visibility with endoscopists’ visibility scoring and objective color difference (CD) value. Methods: From April 2015 to September 2015, we analyzed 27 pictures and 100 videos of colorectal lesions. Combinations of structure enhancement (B3, A3, A5) and CE (CE 0, 1, 3) were evaluated and CD values of 2 corresponding modes (high enhancement: A5 + CE3, preset low enhancement: A3 + CE0) were calculated using marketed software. In the video, these 2 modes were evaluated. All pictures and movies were graded by 4 endoscopists using visibility scores: score 4 (excellent) to score 1 (poor). Results: The scores of A3 + CE0 (2.74 ± 1.09) were significantly lower than those of all other higher enhancement settings such as B3 + CE1 (3.11 ± 1.08), A3 + CE1 (3.33 ± 0.91), and A5 + CE3 (3.56 ± 0.74; p < 0.001). The CD value of A5 + CE3 was significantly higher than A3 + CE0 (20.2 ± 6.9 vs. 12.9 ± 5.6, p < 0.001). In the video, the scores for A5 + CE3 were significantly higher than A3 + CE0 (3.27 ± 0.83 vs. 2.53 ± 1.05, p < 0.001). Conclusions: Higher enhancement settings increased visibility of colorectal lesions.

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“…Rex et al 2 addressed these limitations by performing the first multicentre randomised controlled trial directly comparing three adjuncts to high-definition (HD) colonoscopy, namely Endocuff, EndoRings and full-spectrum endoscopy (FUSE) system.…”

Section: Device Assisted Colonoscopy: a Sight For Sore Eyes?mentioning

confidence: 99%

Highlights from the literature

McGowan

Dunne

2018

Frontline Gastroenterol

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High-definition colonoscopy versus Endocuff versus EndoRings versus full-spectrum endoscopy for adenoma detection at colonoscopy: a multicenter randomized trial

Cited by 114 publications

References 23 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

High Enhancement Settings for White Light Observation Improves Colorectal Polyp Visibility in Color Difference Value and an Endoscopist’s Visibility

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