Harsh K Patel1, Viveksandeep Thoguluva Chandrasekar2, Sachin Srinivasan3, Suchi K Patel4, Chandra S Dasari5, Munraj Singh6, Elise Le Cam6, Marco Spadaccini7, Douglas Rex8, Prateek Sharma5. 1. Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, Louisiana, USA. 2. Department of Gastroenterology, University of Kansas Hospital, Kansas City, Kansas, USA. 3. Department of Internal Medicine, University of Kansas School of Medicine, Wichita, Kansas, USA. 4. Department of Statistics, Anand Institute of Management, Anand, Gujarat, India. 5. Department of Gastroenterology, Veterans Affairs Medical Center, Kansas City, Missouri, USA. 6. Faculty of Medicine, The University of Queensland Ochsner Clinical School, New Orleans, Louisiana, USA. 7. Department of Gastroenterology, Humanitas University, Milan, Italy. 8. Department of Gastroenterology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Abstract
BACKGROUND AND AIMS: Multiple randomized controlled trials (RCTs) using the second-generation distal attachment cuff device (Endocuff Vision; Olympus America, Center Valley, Pa, USA) have reported conflicting results in improving adenoma detection rate (ADR) compared with standard high-definition colonoscopy without the distal attachment. We conducted a systematic review and meta-analysis of RCTs to compare outcomes between second-generation cuff colonoscopy (CC) versus colonoscopy without the distal attachment (standard colonoscopy [SC]). METHODS: An electronic literature search was performed using PubMed, Google Scholar, Embase, and Cochrane Library through May 2020. The primary outcome was reporting of ADR, and secondary outcomes were polyp detection rate (PDR), mean withdrawal time, mean adenomas per colonoscopy (APC), sessile serrated lesion detection rate, and adverse events. Pooled rates and risk ratios (RRs) with 95% confidence intervals were reported. RESULTS: Eight RCTs with 5695 patients were included in the final analysis, with 2862 patients (mean age, 62.8 years; 52.9% men) in the CC group and 2833 patients (mean age, 62.6 years; 54.2% men) in the SC group. Compared with SC, use of CC was associated with a significant improvement in ADR (49.8% vs 45.6%, respectively; RR, 1.12; P = .02), PDR (58.1% vs 53%, respectively; RR, 1.12; P = .009), and APC (P < .01). Furthermore, use of CC had a .93-minute lower mean withdrawal time (P < .01) when compared with SC. The difference in ADR was larger in the screening/surveillance population (6.5%, P = .02) and when used by endoscopists with ADRs <30% (9.4%, P = .03). CONCLUSIONS: The results of this meta-analysis of randomized trials show a significant improvement in ADR and APC with shorter withdrawal times using the second-generation cuff device compared with SC.
BACKGROUND AND AIMS: Multiple randomized controlled trials (RCTs) using the second-generation distal attachment cuff device (Endocuff Vision; Olympus America, Center Valley, Pa, USA) have reported conflicting results in improving adenoma detection rate (ADR) compared with standard high-definition colonoscopy without the distal attachment. We conducted a systematic review and meta-analysis of RCTs to compare outcomes between second-generation cuff colonoscopy (CC) versus colonoscopy without the distal attachment (standard colonoscopy [SC]). METHODS: An electronic literature search was performed using PubMed, Google Scholar, Embase, and Cochrane Library through May 2020. The primary outcome was reporting of ADR, and secondary outcomes were polyp detection rate (PDR), mean withdrawal time, mean adenomas per colonoscopy (APC), sessile serrated lesion detection rate, and adverse events. Pooled rates and risk ratios (RRs) with 95% confidence intervals were reported. RESULTS: Eight RCTs with 5695 patients were included in the final analysis, with 2862 patients (mean age, 62.8 years; 52.9% men) in the CC group and 2833 patients (mean age, 62.6 years; 54.2% men) in the SC group. Compared with SC, use of CC was associated with a significant improvement in ADR (49.8% vs 45.6%, respectively; RR, 1.12; P = .02), PDR (58.1% vs 53%, respectively; RR, 1.12; P = .009), and APC (P < .01). Furthermore, use of CC had a .93-minute lower mean withdrawal time (P < .01) when compared with SC. The difference in ADR was larger in the screening/surveillance population (6.5%, P = .02) and when used by endoscopists with ADRs <30% (9.4%, P = .03). CONCLUSIONS: The results of this meta-analysis of randomized trials show a significant improvement in ADR and APC with shorter withdrawal times using the second-generation cuff device compared with SC.
Authors: Faisal Kamal; Muhammad Ali Khan; Wade Lee-Smith; Sachit Sharma; Ashu Acharya; Zaid Imam; Umer Farooq; John Hanson; Vian Pulous; Muhammad Aziz; Saurabh Chandan; Abdul Kouanda; Sun-Chuan Dai; Craig A Munroe; Colin W Howden Journal: Endosc Int Open Date: 2022-10-17
Authors: Martin Floer; Laura Tschaikowski; Michael Schepke; Radoslaw Kempinski; Katarzyna Neubauer; Elzbieta Poniewierka; Steffen Kunsch; Detlev Ameis; Hauke Sebastian Heinzow; Agneta Auer; Hartmut H Schmidt; Volker Ellenrieder; Tobias Meister Journal: United European Gastroenterol J Date: 2021-02-16 Impact factor: 4.623