Cap cuff–assisted colonoscopy versus standard colonoscopy for adenoma detection: a randomized back-to-back study

• Published in: Gastrointestinal endoscopy 2018-01, Vol.87 (1), p.232-240
• Main Authors: De Palma, Giovanni D., MD, Giglio, Mariano C., MD, Bruzzese, Dario, PhD, Gennarelli, Nicola, MD, Maione, Francesco, MD, Siciliano, Saverio, MD, Manzo, Benedetta, MD, Cassese, Gianluca, MD, Luglio, Gaetano, MD
• Format: Article
• Language: English
• Subjects: Gastroenterology and Hepatology
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2016.12.027

Background and Aims EndoCuff is a disposable device applied to standard colonoscopes to improve mucosal visualization. Randomized parallel trials have shown that EndoCuff increases the adenoma detection rate (ADR). The primary aim of this study was to compare the ADR between EndoCuff-assisted colonoscopies (EAC) and standard colonoscopies within a randomized back-to-back trial. Methods This was a single-center randomized crossover study (NCT02374515) involving adult patients undergoing screening, surveillance, or diagnostic colonoscopy. Participants received back-to-back standard colonoscopies and EACs in a random order, performed by the same endoscopist. All polyps were excised, but only those proven at histology to be adenomas were considered for analysis. Results From February 2015 to March 2016, a total of 288 patients were enrolled, and 274 were included in the per-protocol analysis. Compared with standard colonoscopies, EACs increased the ADR (29.6% vs 26.3%; P  < .01) and the number of diagnosed adenomas (176 vs 129; P  < .01), particularly in the left (73 vs 46; P  < .01) and right sides of the colon (83 vs 63; P  < .01). EAC increased the detection of adenomas