Use of the Endocuff during routine colonoscopy examination improves adenoma detection: A meta-analysis

Matthew Chin, William Karnes, M Mazen Jamal, John G Lee, Robert Lee, Jason Samarasena, Matthew L Bechtold, Douglas L Nguyen, Matthew Chin, William Karnes, M Mazen Jamal, John G Lee, Robert Lee, Jason Samarasena, Matthew L Bechtold, Douglas L Nguyen

Abstract

Aim: To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy.

Methods: Scopus, Cochrane databases, MEDLINE/PubMed, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meeting were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy (EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerSimonian and Laird models with the odds ratio (OR) to assess adenoma detection, cecal intubation rate, and complications performed.

Results: Nine studies (n = 5624 patients) were included in the analysis. Compared to standard colonoscopy, procedures performed with EC had higher frequencies for adenoma (OR = 1.49, 95%CI: 1.23-1.80; P = 0.03), and sessile serrated adenomas detection (OR = 2.34 95%CI: 1.63-3.36; P < 0.001). There was no significant difference in cecal intubation rates between the EAC group and standard colonoscopy (OR = 1.26, 95%CI: 0.70-2.27, I2 = 0%; P = 0.44). EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency for perforation.

Conclusion: The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy.

Keywords: Adenoma detection; Colonoscopy; Endocuff.

Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Article selection.
Figure 2
Figure 2
Cecal intubation.
Figure 3
Figure 3
Adenoma detection rate.
Figure 4
Figure 4
Right-sided polyp detection.
Figure 5
Figure 5
Sessile serrated adenoma detection.

References

    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.
    1. Draft Recommendation Statement: Colorectal Cancer: Screening. U.S. Preventive Services Task Force. October 2015. Available from: .
    1. Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, Jemal A, Schymura MJ, Lansdorp-Vogelaar I, Seeff LC, et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116:544–573.
    1. Rex DK, Cutler CS, Lemmel GT, Rahmani EY, Clark DW, Helper DJ, Lehman GA, Mark DG. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology. 1997;112:24–28.
    1. Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology. 2007;132:96–102.
    1. Singh H, Nugent Z, Demers AA, Bernstein CN. Rate and predictors of early/missed colorectal cancers after colonoscopy in Manitoba: a population-based study. Am J Gastroenterol. 2010;105:2588–2596.
    1. Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, Zwierko M, Rupinski M, Nowacki MP, Butruk E. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010;362:1795–1803.
    1. Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, Zauber AG, de Boer J, Fireman BH, Schottinger JE, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370:1298–1306.
    1. Richter JM, Campbell EJ, Chung DC. Interval colorectal cancer after colonoscopy. Clin Colorectal Cancer. 2015;14:46–51.
    1. Lu FI, van Niekerk de W, Owen D, Tha SP, Turbin DA, Webber DL. Longitudinal outcome study of sessile serrated adenomas of the colorectum: an increased risk for subsequent right-sided colorectal carcinoma. Am J Surg Pathol. 2010;34:927–934.
    1. Fujita K, Yamamoto H, Matsumoto T, Hirahashi M, Gushima M, Kishimoto J, Nishiyama K, Taguchi T, Yao T, Oda Y. Sessile serrated adenoma with early neoplastic progression: a clinicopathologic and molecular study. Am J Surg Pathol. 2011;35:295–304.
    1. Lenze F, Beyna T, Lenz P, Heinzow HS, Hengst K, Ullerich H. Endocuff-assisted colonoscopy: a new accessory to improve adenoma detection rate? Technical aspects and first clinical experiences. Endoscopy. 2014;46:610–614.
    1. Marsano J, Tzimas D, Mckinley M, Robbins D, Mammen A, Sun E, Chugh P, Razavi F, Hasan N, Buscaglia J, et al. Endocuff assisted colonoscopy increases adenoma detection rates: a multi-center study. Gastrointest Endosc. 2014;79:AB550.
    1. Biecker E, Floer M, Heinecke A, Ströbel P, Böhme R, Schepke M, Meister T. Novel endocuff-assisted colonoscopy significantly increases the polyp detection rate: a randomized controlled trial. J Clin Gastroenterol. 2015;49:413–418.
    1. Floer M, Biecker E, Fitzlaff R, Röming H, Ameis D, Heinecke A, Kunsch S, Ellenrieder V, Ströbel P, Schepke M, et al. Higher adenoma detection rates with endocuff-assisted colonoscopy - a randomized controlled multicenter trial. PLoS One. 2014;9:e114267.
    1. Tsiamoulos ZP, Mirsa R, Bourikas LA, Rajaratnam R, Patel KP, Thomas-Gibson S, Haycock A, Suzuki N, Beintaris I, Saunders BP. Endocuff-vision: impact on colonoscopist performance during screening. Gastrointest Endosc. 2015:81 Suppl 5: AB209.
    1. van Doorn SC, van der Vlugt M, Depla A, Wientjes CA, Mallant-Hent RC, Siersema PD, Tytgat K, Tuynman H, Kuiken SD, Houben G, et al. Adenoma detection with Endocuff colonoscopy versus conventional colonoscopy: a multicentre randomised controlled trial. Gut. 2015 Epub ahead of print.
    1. Shah-Ghassemzadeh M, Baek M, Jackson C, Lunn J, Nguyen C, Serrao S, Juma D, Strong R. Endocuff-assisted colonoscopy increases sessile serrated adenoma/polyp detection and adenoma detection rates: a quality improvement study. Am J Gastroenterol. 2015;110:S666.
    1. Cattau EL, Leal RK, Ormseth EJ, Aycock R, Ward JD, Thompson BF, Dragutsky M, Towne C. The effect of Endocuff-assisted colonoscopy on adenoma detection rate: a randomized trial in community ambulatory surgical centers. Am J Gastroenterol. 2015;110:S602.
    1. Grewal J, Chin M, Chen C, Karnes W. Endocuff-assisted colonoscopy improves sessile serrated adenoma detection rate: a single academic center observational study. Am J Gastroenterol. 2015;110:S626.
    1. Chin M, Grewal J, Chen C, Karnes W. Endocuff-assisted colonoscopy: a single-center experience with an average-risk, asymptomatic population. Am J Gastroenterol. 2015;110:S613.
    1. Tsiamoulos ZP, Saunders BP. A new accessory, endoscopic cuff, improves colonoscopic access for complex polyp resection and scar assessment in the sigmoid colon (with video) Gastrointest Endosc. 2012;76:1242–1245.
    1. Nguyen DL, Wieland M. Risk factors predictive of poor quality preparation during average risk colonoscopy screening: the importance of health literacy. J Gastrointestin Liver Dis. 2010;19:369–372.
    1. Ng SC, Tsoi KK, Hirai HW, Lee YT, Wu JC, Sung JJ, Chan FK, Lau JY. 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.
    1. Westwood DA, Alexakis N, Connor SJ. Transparent cap-assisted colonoscopy versus standard adult colonoscopy: a systematic review and meta-analysis. Dis Colon Rectum. 2012;55:218–225.
    1. Dik VK, Gralnek IM, Segol O, Suissa A, Moons LM, Domanov S, Segev M, Rex DK, Siersema PD. Comparing standard colonoscopy with EndoRings” colonoscopy: a randomized, multicenter tandem colonoscopy study interim results of the CLEVER study. Gastroenterology. 2014;146:S160.
    1. Halpern Z, Ishaq S, Neumann H, Dobosz N, Viale E, Hoffman A, Hendel J, Senturk H, Kiesslich R. G-EYE colonoscopy significantly improves adenoma detection rates initial results of a multicenter prospective cohort study. Gastroenterology. 2014;146:S402.
    1. Gross S, Halpern Z, Santo E, Kiesslich R, Hoffman A, Pochapin M, Shpak B. A novel balloon-colonoscope for increased polyp/adenoma detection rate: results of a randomized tandem study. Am J Gastroenterol. 2013;108:S632–S633.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi