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. 2019 Dec;7(12):E1585-E1591.
doi: 10.1055/a-0996-7891. Epub 2019 Nov 25.

Comparison of colon adenoma detection rates using cap-assisted and Endocuff-assisted colonoscopy: a randomized controlled trial

Joseph Marsano  1 , Sheeva Johnson  2 , Stephanie Yan  2 , Latifat Alli-Akintade  1 , Machelle Wilson  3 , Amar Al-Juburi  1 , Jesse Stondell  1 , Sooraj Tejaswi  1
Affiliations

Comparison of colon adenoma detection rates using cap-assisted and Endocuff-assisted colonoscopy: a randomized controlled trial

Joseph Marsano et al. Endosc Int Open. 2019 Dec.

Abstract

Objectives and study aim Colonoscopy prevents colorectal cancer by removing adenomatous polyps, but missed adenomas lead to interval cancers. Different devices have been used to increase adenoma detection rates (ADR). Two such devices of interest are the transparent cap (Olympus) and Endocuff (ARC Medical). Our study aimed to compare differences in ADR between Endocuff-assisted colonoscopy (EAC), cap-assisted colonoscopy (CAC) and standard colonoscopy (SC). Patients and methods A sample size of 126 subjects was calculated to determine an effect size of 30 %. Patients undergoing screening or surveillance colonoscopy between March 2016 and January 2017 were randomized to SC, CAC or EAC groups. Three experienced endoscopists performed all colonoscopies. Patient demographics, procedure indication, Boston Bowel Prep Score (BBPS), withdrawal time, polyp size, location, histopathology, were analyzed. Results There was no difference in ADR (52 %, 40 % and 54 %) in the SC, CAC and EAC groups respectively ( P = 0.4). Similar findings were also observed for proximal ADR (45 %, 35 %, and 50 %, P = 0.4) and SSA detection rate (16 %, 14 %, and 23 %, P = 0.5). EAC detected higher mean ADR per colonoscopy compared to CAC (1.70 vs 0.76, P = 0.01). However, there was no significant difference in mean ADR per positive colonoscopy (2.08, 1.63, and 2.59, P = 0.21). Conclusion In a randomized controlled trial comparing AC to CAC and SC, neither device conferred additional benefits in ADR among high detectors. When comparing each device, EAC may be better than CAC at detecting more total adenomas.

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Conflict of interest statement

Competing interests None

Figures

Fig. 1
Fig. 1
Transparent cap fixed to the end of a colonoscope.
Fig. 2
Fig. 2
Endocuff with two rows of soft projections fixed to the end of a colonoscope.
Fig. 3
Fig. 3
Consolidated Standards of Reporting Trials (CONSORT) randomization flowchart. Of the eligible patients, only 235 could be contacted by phone or medical record. All randomized patients completed the study and were analyzed.
See this image and copyright information in PMC

Comment in

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