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Endocuff Vision device improves adenoma detection in colonoscopy
Colonoscopies performed with the aid of the Endocuff Vision device yielded better adenoma detection rates than standard procedures, according to a study published in Gut.
Colin J. Rees, MD, of the department of gastroenterology at the South Tyneside NHS Foundation Trust and the Northern Institute for Cancer Research at Newcastle University in the U.K, and colleagues conducted a randomized controlled trial to compare colonoscopies performed with and without the device, which the FDA recently cleared for improving adenoma detection rates (ADR).
The Endocuff Vision (EV; Arc Medical Design, Olympus) is a device mounted on the tip of a colonoscope that uses retractable arms to hold back colonic folds and enhance mucosal visualization during a colonoscopy. As Healio Gastroenterology and Liver Disease previously reported, a recent large randomized controlled trial showed the device detected more adenomas per patient, but failed to increase adenoma detection rates (ADR).
For the current study, investigators randomly assigned 1,772 patients referred for colonoscopy for clinical symptoms to one of two groups. One group (n = 888) underwent EV-assisted colonoscopy (EAC) and the control group (n = 884) underwent standard colonoscopy (SC). The researchers measured ADR, mean adenomas pre-procedure, size and location of adenomas, sessile serrated polyps, EV removal rate, cecal intubation rate, procedural time, patient experience, effect of EV on workload and adverse events.
Rees and colleagues found that the EAC group had significantly higher ADR (40.9% vs. 36.2%, P = .02) and the odds of adenoma detection was 22% higher compared with the control group. The improvement was driven by a 10.8% ADR increase in a subgroup that tested positive on a fecal occult blood test (50.9% SC vs. 61.7% EAC, P < .001).
Patients in the EAC group also had higher detection of mean adenomas per procedure, sessile serrated polyps, left-sided, diminutive, small adenomas and cancers (cancer 4.1% vs. 2.3%, P = .02). There were no significant adverse effects in the EAC group.
Rees and colleagues wrote that the device should be used to improve colonoscopic detection.
“The results of the [study] demonstrate that Endocuff Vision is a safe device, which improves ADR in the fecal occult blood test positive screening population,” they wrote. “It speeds up procedures and is generally well tolerated by patients.” – by Alex Young
Disclosures: Rees has received research grants from ARC medical and Norgine. Please see the full study for a list of all other authors’ relevant financial disclosures.