The effect of the endoscopic device Endocuff™/Endocuff vision™ on quality standards in colonoscopy: A systematic review and meta‐analysis of randomized trials

Abstract

Aim:The adenoma detection rate (ADR) is an important quality measure, with a high ADR reflecting high-quality colonoscopy. This systematic review and meta-analysis aimed to assess the effects of Endocuff™/Endocuff Vision™-assisted colonoscopy (EAC) versus standard colonoscopy (SC) on ADR and other clinical, patient and resource-use outcomes. Method: MEDLINE, EMBASE, Web of Science, Scopus and the Cochrane Central Register of Controlled Trials were searched for full papers reporting randomized studies comparing EAC with SC. The primary outcome was ADR. Secondary outcomes comprised key polyp/adenoma detection, procedure-related, patient-related and health economic measures. Random effects meta-analyses provided pooled estimates of outcomes [risk ratio (RR) or mean difference (MD), with 95% confidence intervals (CI)].Results: Twelve parallel-group randomized controlled trials (RCTs) and three crossover RCTs with data on 9140 patients were included. EAC significantly increased the ADR (RR 1.18, 95% CI 1.09-1.29), mean adenomas per procedure (MAP) (MD 0.19, 95% CI 0.06-0.33), polyp detection rate (PDR) (RR 1.20, 95% CI 1.10-1.30) and mean polyps per procedure (MPP) (MD 0.39, 95% CI 0.14-0.63) versus SC. EAC significantly increased segmental PDR versus SC in the sigmoid (RR 2.02, 95% CI 1.64-2.49), transverse (RR 1.63, 95% CI 1.09-2.42), ascending (RR 1.74,) and caecal segments (RR 1.91, 95% CI 1.29-2.82). Procedure-related variables did not differ between arms. There were insufficient data for meta-analysis of health economic or patient-centred outcomes.Conclusions: EAC increased ADR, MAP, PDR and MPP versus SC without detrimental effects on procedure measures. Cost-effectiveness and patient experience data are lacking and would be valuable to inform practice recommendations.

Endocuff Vision-Assisted Resection for Difficult Colonic Lesions—Preliminary Results of a Multicenter, Prospective Randomized Pilot Study

“…ECV is a second-generation device that replaced the original Endocuff, which had two rows of shorter, firmer projections. The main aim of the Endocuff is to improve ADRs, and this has been investigated in several studies [11,[17][18][19][20][21][22][23].…”

Artificial intelligence and the push for small adenomas: all we need?

“…Furthermore, a cap device, mostly Endocuff Vision (Olympus, Tokyo, Japan), was used at the discretion of the endoscopist. This device has been shown to increase polyp yield in a recent meta-analysis [39], and also recently in a FIT-based randomized screening colonoscopy study published in Endoscopy [40]. Endocuff was used in about 70 % of colonoscopies in the Ahmad et al study, and it is a shame that its use was not standardized.…”