Download PDF
Endoscopy 2017; 49(11): 1061-1068
DOI: 10.1055/s-0043-117879
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Higher adenoma detection rate with the endocuff: a randomized trial

Coty González-Fernández
1   Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
,
David García-Rangel
1   Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
,
Nancy Edith Aguilar-Olivos
2   Gastrointestinal Endoscopy Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico
,
Rafael Barreto-Zúñiga
1   Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
,
Adriana Fabiola Romano-Munive
1   Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
,
Guido Grajales-Figueroa
1   Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
,
Luis Eduardo Zamora-Nava
1   Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
,
Félix Ignacio Téllez-Avila
1   Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
› Author Affiliations
Further Information

Publication History

submitted 16 September 2016

accepted after revision 06 July 2017

Publication Date:
12 September 2017 (online)

Also available at
    Permissions and Reprints

Abstract

Background and study aim Different techniques have been introduced to improve the endoscopist’s view and enhance the detection of polyps. The endocuff is a polymer sleeve cap that is connected to the tip of the colonoscope in order to improve visualization of the mucosa during colonoscopy. The aim of the study was to compare adenoma detection rates (ADR) of endocuff-assisted colonoscopy and conventional colonoscopy.

Patients and methods Patients 50 years or older were randomized into two groups: an endocuff-assisted colonoscopy group and a conventional colonoscopy group without the endocuff.

Results A total of 337 patients were included: 174 in the endocuff group and 163 in the conventional group. The median age was 61 years (interquartile range 55 – 70 years), and 74 % were women. The ADR was higher in the endocuff group than in the conventional group (22.4 % vs. 13.5 %; P = 0.02). The mean number of adenomas was 0.30 (SD 0.25) in the endocuff group and 0.21 (SD 0.26) in the conventional group (P  = 0.02). The rate of ileal intubation was lower in the endocuff group (73 % vs. 87 %; P < 0.001). No serious adverse events occurred with the use of the endocuff.

Conclusions Endocuff colonoscopy achieved a greater ADR than conventional colonoscopy.

Trial registered at ClinicalTrials.gov (NTC02387593).

 

  • References

  • 1 Pabby A, Schoen RE, Weissfeld JL. et al. Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial. Gastrointest Endosc 2005; 61: 385-391
    CrossrefPubMedGoogle Scholar
  • 2 Coe SG, Crook JE, Diehl NN. et al. An endoscopic quality improvement program improves detection of colorectal adenomas. Am J Gastroenterol 2013; 108: 219-226
    CrossrefPubMedGoogle Scholar
  • 3 Sharma P, Gupta N, Kuipers EJ. et al. Advanced imaging in colonoscopy and its impact on quality. Gastrointest Endosc 2014; 79: 28-36
    CrossrefPubMedGoogle Scholar
  • 4 Buchner AM, Shahid MW, Heckman MG. et al. High-definition colonoscopy detects colorectal polyps at a higher rate than standard white-light colonoscopy. Clin Gastroenterol Hepatol 2010; 8: 364-370
    CrossrefPubMedGoogle Scholar
  • 5 Davila RE. Chromoendoscopy. Gastrointest Endosc Clin N Am 2009; 19: 193-208
    CrossrefPubMedGoogle Scholar
  • 6 Mamula P, Tierney WM, Banerjee S. et al. Devices to improve colon polyp detection. Gastrointest Endosc 2011; 73: 1092-1097
    CrossrefPubMedGoogle Scholar
  • 7 de Wijkerslooth TR, Stoop EM, Bossuyt PM. et al. Adenoma detection with cap-assisted colonoscopy versus regular colonoscopy: a randomized controlled trial. Gut 2012; 61: 1426-1434
    CrossrefPubMedGoogle Scholar
  • 8 Ng SC, Tsoi KK, Hirai HW. et al. The efficacy of cap-assisted colonoscopy in polyp detection and cecal intubation: a meta-analysis of randomized controlled trials. Am J Gastroenterol 2012; 107: 1165-1173
    CrossrefPubMedGoogle Scholar
  • 9 Lenze F, Beyna T, Lenz P. et al. Endocuff-assisted colonoscopy: a new accessory to improve adenoma detection rate? Technical aspects and first clinical experiences. Endoscopy 2014; 46: 610-614
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Biecker E, Floer M, Heinecke A. et al. Novel endocuff-assisted colonoscopy significantly increases the polyp detection rate: a randomized controlled trial. J Clin Gastroenterol 2015; 49: 413-418
    CrossrefPubMedGoogle Scholar
  • 11 Floer M, Biecker E, Fitzlaff R. et al. Higher adenoma detection rates with endocuff-assisted colonoscopy – a randomized controlled multicenter trial. PLoS One 2014; 9: e114267
    CrossrefPubMedGoogle Scholar
  • 12 Calderwood AH, Jacobson BC. Comprehensive validation of the Boston Bowel Preparation Scale. Gastrointest Endosc 2010; 72: 686-692
    CrossrefPubMedGoogle Scholar
  • 13 Marcondes FO, Dean KM, Schoen RE. et al. The impact of exclusion criteria on a physician’s adenoma detection rate. Gastrointest Endosc 2015; 82: 668-675
    CrossrefPubMedGoogle Scholar
  • 14 Clark BT, Protiva P, Nagar A. et al. Quantification of adequate bowel preparation for screening or surveillance colonoscopy in men. Gastroenterology 2016; 150: 396-405
    CrossrefPubMedGoogle Scholar
  • 15 de Lascurain-Morhan E. Prevalence of adenomas and carcinomas of the colon. Results of the rectosigmoid exam. Rev Gastroenterol Mex 2001; 66: 131-136
    PubMedGoogle Scholar
  • 16 Garcia-Osogobio S, Tellez-Avila FI, Mendez-Sánchez N. et al. Results of the first program of colorectal cancer screening in Mexico. Endoscopia 2015; 27: 59-63
    CrossrefPubMedGoogle Scholar
  • 17 Hewett DG, Kahi CJ, Rex DK. Does colonoscopy work?. J Natl Compr Canc Netw 2010; 8: 67-76
    CrossrefPubMedGoogle Scholar
  • 18 Kaminski MF, Regula J, Kraszewska E. et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 2010; 362: 1795-1803
    CrossrefPubMedGoogle Scholar
  • 19 Rex DK, Schoenfeld PS, Cohen J. et al. Quality indicators for colonoscopy. Gastrointest Endosc 2015; 81: 31-53
    CrossrefPubMedGoogle Scholar
  • 20 Tellez-Ávila FI, Murcio-Pérez E, Saul A. et al. Efficacy and tolerability of low-volume (2 L) versus single- (4 L) versus split-dose (2 L + 2 L) polyethylene glycol bowel preparation for colonoscopy: randomized clinical trial. Dig Endosc 2014; 26: 731-736
    CrossrefPubMedGoogle Scholar
  • 21 Lebwohl B, Capiak K, Neugut AI. et al. Risk of colorectal adenomas and advanced neoplasia in Hispanic, black and white patients undergoing screening colonoscopy. Aliment Pharmacol Ther 2012; 35: 1467-1473
    CrossrefPubMedGoogle Scholar
  • 22 Lee B, Holub J, Peters D. et al. Prevalence of colon polyps detected by colonoscopy screening of asymptomatic Hispanic patients. Dig Dis Sci 2012; 57: 481-488
    CrossrefPubMedGoogle Scholar
  • 23 Rex DK, Cutler CS, Lemmel GT. et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997; 112: 24-28
    CrossrefPubMedGoogle Scholar
  • 24 Bressler B, Paszat LF, Vinden C. et al. Colonoscopic miss rates for right-sided colon cancer: a population based analysis. Gastroenterology 2004; 127: 452-456
    CrossrefPubMedGoogle Scholar
  • 25 Atkins L, Hunkeler EM, Jensen CD. et al. Factors influencing variation in physician adenoma detection rates: a theory-based approach for performance improvement. Gastrointest Endosc 2016; 83: 617-626
    CrossrefPubMedGoogle Scholar
  • 26 Matsuda T, Kawano H, Chiu HM. Screening colonoscopy: what is the most reliable modality for the detection and characterization of colorectal lesions?. Dig Endosc 2015; 27: 25-29
    PubMedGoogle Scholar
  • 27 van Doorn SC, van der Vlugt M, Depla A. et al. Adenoma detection with Endocuff colonoscopy versus conventional colonoscopy: a multicentre randomised controlled trial. Gut 2017; 66: 438-445
    CrossrefPubMedGoogle Scholar
  • 28 Chin M, Karnes W, Jamal MM. et al. Use of the Endocuff during routine colonoscopy examination improves adenoma detection: a meta-analysis. World J Gastroenterol 2016; 22: 9642-9649
    CrossrefPubMedGoogle Scholar
  • 29 De Palma GD, Giglio MC, Bruzzese D. et al. Cap cuff-assisted colonoscopy versus standard colonoscopy for adenoma detection: a randomized back-to-back study. Gastrointest Endosc 2017; DOI: 10.1016/j.gie.2016.12.027.
    CrossrefPubMedGoogle Scholar