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Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial
BACKGROUND AND AIMS: Adenoma detection rate (ADR) in colon cancer screening is most important for cancer prophylaxis. This work is the first three‐armed randomised controlled clinical trial aimed at comparing a head‐to‐head setting standard colonoscopy (SC) with Endocuff‐assisted colonoscopy (EC) an...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259258/ https://www.ncbi.nlm.nih.gov/pubmed/33349200 http://dx.doi.org/10.1177/2050640620982952 |
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author | Floer, Martin Tschaikowski, Laura Schepke, Michael Kempinski, Radoslaw Neubauer, Katarzyna Poniewierka, Elzbieta Kunsch, Steffen Ameis, Detlev Heinzow, Hauke Sebastian Auer, Agneta Schmidt, Hartmut H. Ellenrieder, Volker Meister, Tobias |
author_facet | Floer, Martin Tschaikowski, Laura Schepke, Michael Kempinski, Radoslaw Neubauer, Katarzyna Poniewierka, Elzbieta Kunsch, Steffen Ameis, Detlev Heinzow, Hauke Sebastian Auer, Agneta Schmidt, Hartmut H. Ellenrieder, Volker Meister, Tobias |
author_sort | Floer, Martin |
collection | PubMed |
description | BACKGROUND AND AIMS: Adenoma detection rate (ADR) in colon cancer screening is most important for cancer prophylaxis. This work is the first three‐armed randomised controlled clinical trial aimed at comparing a head‐to‐head setting standard colonoscopy (SC) with Endocuff‐assisted colonoscopy (EC) and cap‐assisted colonoscopy (CAC) for improvement of ADR. METHODS: Patients from Poland and Germany with independent indication for colonoscopy were randomised into three arms of this trial: EC, CAC and SC. Exclusion criteria were age <18 years, active Crohn's disease or ulcerative colitis, known stenosis and post‐colonic resection status. RESULTS: A total of 585 patients (195 SC, 189 EC and 186 CAC) were enrolled in this study. Indications were not different between the groups (colorectal cancer screening 51%, diagnostic colonoscopy in 31% and post‐polypectomy follow‐up in 18%; p = 0.94). Withdrawal time was a mean of 7 min in all groups (p = 0.658), and bowel preparation did not differ between the groups. The time to reach the caecum was significantly reduced when using the cap (a mean of 6 min for CAC vs. 7 min for SC; p = 0.0001). There was no significant difference in the primary outcome of the ADR between the groups (EC 32%, CAC 30%, SC 30%; p = 0.815). EC proved to be superior (EC vs. SC) in the sigmoid colon and transverse colon for polyp detection. CONCLUSION: The use of EC increased the total number of polyps seen during colonoscopy. In contrast to recent studies, no significant improvement of the ADR was detected. |
format | Online Article Text |
id | pubmed-8259258 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82592582021-07-12 Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial Floer, Martin Tschaikowski, Laura Schepke, Michael Kempinski, Radoslaw Neubauer, Katarzyna Poniewierka, Elzbieta Kunsch, Steffen Ameis, Detlev Heinzow, Hauke Sebastian Auer, Agneta Schmidt, Hartmut H. Ellenrieder, Volker Meister, Tobias United European Gastroenterol J Endoscopy BACKGROUND AND AIMS: Adenoma detection rate (ADR) in colon cancer screening is most important for cancer prophylaxis. This work is the first three‐armed randomised controlled clinical trial aimed at comparing a head‐to‐head setting standard colonoscopy (SC) with Endocuff‐assisted colonoscopy (EC) and cap‐assisted colonoscopy (CAC) for improvement of ADR. METHODS: Patients from Poland and Germany with independent indication for colonoscopy were randomised into three arms of this trial: EC, CAC and SC. Exclusion criteria were age <18 years, active Crohn's disease or ulcerative colitis, known stenosis and post‐colonic resection status. RESULTS: A total of 585 patients (195 SC, 189 EC and 186 CAC) were enrolled in this study. Indications were not different between the groups (colorectal cancer screening 51%, diagnostic colonoscopy in 31% and post‐polypectomy follow‐up in 18%; p = 0.94). Withdrawal time was a mean of 7 min in all groups (p = 0.658), and bowel preparation did not differ between the groups. The time to reach the caecum was significantly reduced when using the cap (a mean of 6 min for CAC vs. 7 min for SC; p = 0.0001). There was no significant difference in the primary outcome of the ADR between the groups (EC 32%, CAC 30%, SC 30%; p = 0.815). EC proved to be superior (EC vs. SC) in the sigmoid colon and transverse colon for polyp detection. CONCLUSION: The use of EC increased the total number of polyps seen during colonoscopy. In contrast to recent studies, no significant improvement of the ADR was detected. John Wiley and Sons Inc. 2021-02-16 /pmc/articles/PMC8259258/ /pubmed/33349200 http://dx.doi.org/10.1177/2050640620982952 Text en © 2020 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Endoscopy Floer, Martin Tschaikowski, Laura Schepke, Michael Kempinski, Radoslaw Neubauer, Katarzyna Poniewierka, Elzbieta Kunsch, Steffen Ameis, Detlev Heinzow, Hauke Sebastian Auer, Agneta Schmidt, Hartmut H. Ellenrieder, Volker Meister, Tobias Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial |
title | Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial |
title_full | Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial |
title_fullStr | Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial |
title_full_unstemmed | Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial |
title_short | Standard versus Endocuff versus cap‐assisted colonoscopy for adenoma detection: A randomised controlled clinical trial |
title_sort | standard versus endocuff versus cap‐assisted colonoscopy for adenoma detection: a randomised controlled clinical trial |
topic | Endoscopy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259258/ https://www.ncbi.nlm.nih.gov/pubmed/33349200 http://dx.doi.org/10.1177/2050640620982952 |
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