The Endocuff Vision endoscopy device achieved a higher adenoma detection rate and missed fewer adenomas than cap-assisted endoscopy, according to study results.
Rajaratnam Rameshshanker, MBBS, MRCP, from St. Mark’s Hospital and Academic Institute in the United Kingdom, and colleagues wrote that devices like Endocuff Vision (Arc Medical Design) and cap-assisted endoscopy (CAC) are designed to counteract some of the factors that make adenoma detection difficult, and they sought to compare the devices head-to-head.
“Reasons for lesions not being detected at colonoscopy include suboptimal technique; shorter withdrawal time; inadequate bowel preparation; presence of flat, depressed, or subtle lesions; and the inability to visualize the proximal side of haustral folds or flexures,” they wrote. “Optical imaging innovations and technological developments in the field of colonoscopy have attempted to decrease the adenoma miss rate with the introduction of high-definition endoscopes, electronic chromoendoscopy, wide-angle colonoscopes, retrograde viewing devices and adjunct disposable distal attachments.”
Researchers performed a randomized, single-center, tandem colonoscopy trial to compare the two devices. The procedures were performed by the same, experienced gastroenterology fellow on the same day, first with Endocuff Vision and then CAC, or vice-versa.
Of 154 total patients, 78 underwent CAC first (50.6%).
Rameshshanker and colleagues found that compared with CAC, colonoscopy with Endocuff Vision had a lower the polyp miss rate (26.1% vs. 8.4%; P < .001), adenoma miss rate (19% vs. 6%; P = .002) and diminutive adenoma miss rate (19.6% vs. 1.8%; P < .001).
Although there was no difference in the miss rates for small adenomas or adenomas larger than 10 mm, the mean number of adenomas found per procedure was higher with the Endocuff Vision than in CAC (1.5 vs. 0.8; P < .001). While Endocuff Vision had a shorter cecal intubation time, its withdrawal time was longer.
“Endocuff Vision surpassed the performance of cap-assisted colonoscopy by significantly reducing the adenoma miss rates in the hands of moderately experienced endoscopists, albeit at the cost of the Endocuff Vision needing to be removed in a small minority of technically difficult colonoscopies,” Rameshshanker and colleagues wrote. – by Alex Young
Disclosure: Healio Gastroenterology and Liver Disease could not confirm the authors relevant financial disclosures prior to publication.