Endoscopy 2018; 50(04): S17
DOI: 10.1055/s-0038-1637074
ESGE Days 2018 oral presentations
20.04.2018 – Colon: Improving detection
Georg Thieme Verlag KG Stuttgart · New York

META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS SHOWS THAT ENDOCUFF INCREASES COLONOSCOPY ADENOMA DETECTION RATE

K Triantafyllou
1   Attikon University General Hospital, Hepatogastroenterology Unit, Athens, Greece
,
P Gkolfakis
1   Attikon University General Hospital, Hepatogastroenterology Unit, Athens, Greece
,
G Tziatzios
1   Attikon University General Hospital, Hepatogastroenterology Unit, Athens, Greece
,
L Fuccio
2   S. Orsola-Malpighi University Hospital, Department of Medical and Surgical Sciences, Bologna, Italy
,
C Hassan
3   Nuovo Regina Margherita Hospital, Endoscopy Unit, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Endocuff -a plastic device with flexible projections- mounted on the distal tip of the colonoscope, promises improved colonic mucosa inspection. Since data from individual studies are controversial, we aimed to elucidate the effect of Endocuff on adenoma detection rate (ADR) and on advanced ADR (AADR).

Methods:

We performed literature searches in MEDLINE and Cochrane Library for randomized-controlled trials (RCTs) published as full papers in English language evaluating Endocuff-assisted (EAC) versus conventional colonoscopy (CC) in terms of ADR and AADR. The effect size on study outcomes was calculated using fixed or random effect model, as appropriate, and it is shown as OR[95% CI].

Results:

We identified 6 studies; five parallel groups design and one tandem. Five studies evaluated the first-generation and the sixth one the Endocuff-Vision device. One study included screening examinations, another one evaluated FOBT-positive screening and surveillance examinations and four studies evaluated colonoscopies with mixed indications (screening, surveillance and symptomatic). ADR was reported in all 6 studies (3460 examinations). As compared to CC, EAC significantly increased ADR [OR (95% CI)= 1.30 (1.00 – 1.69); I 2= 67%]. Meta-analysis of data from 5 studies (2971 examinations) did not detect any difference between EAC and CC regarding AADR [OR (95% CI)= 0.92 (0.74 – 1.16); I 2= 0%]. There was no evidence of publication bias.

Conclusions:

Meta-analysis of RCTs data provide evidence that EAC increases ADR compared to CC, without increasing AADR. Heterogeneity among the included studies calls for cautious interpretation of the results.