Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Apr;25(4):573-585.
doi: 10.1111/codi.16444. Epub 2022 Dec 28.

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

Martin Walls  1   2 , Britt B S L Houwen  3 , Stephen Rice  2 , Alexander Seager  1   2 , Evelien Dekker  3 , Linda Sharp  2 , Colin J Rees  1   2
Affiliations
Meta-Analysis

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

Martin Walls et al. Colorectal Dis. 2023 Apr.

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, 95% CI 1.26-2.41) 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.

Keywords: ADR; Endocuff; Endocuff vision; adenoma; colonoscopy.

PubMed Disclaimer

References

REFERENCES

    1. Rees CJ, Thomas Gibson S, Rutter MD, Baragwanath P, Pullan R, Feeney M, et al. UK key performance indicators and quality assurance standards for colonoscopy. Gut. 2016;65(12):1923-9.
    1. Rees CJ, Bevan R, Zimmermann-Fraedrich K, Rutter MD, Rex D, Dekker E, et al. Expert opinions and scientific evidence for colonoscopy key performance indicators. Gut. 2016;65(12):2045-60.
    1. Burr NE, Derbyshire E, Taylor J, Whalley S, Subramanian V, Finan PJ, et al. Variation in post-colonoscopy colorectal cancer across colonoscopy providers in English National Health Service: population based cohort study. BMJ. 2019;367:l6090.
    1. Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010;362(19):1795-803.
    1. Lee TJW, Rutter MD, Blanks RG, Moss SM, Goddard AF, Chilton A, et al. Colonoscopy quality measures: experience from the NHS bowel cancer screening programme. Gut. 2012;61(7):1050-7.