Endocuff reduces colonoscopy withdrawal time without sacrificing detection
Compared with standard colonoscopy, use of the Endocuff Vision device decreases withdrawal time without sacrificing lesion detection, according to research published in Clinical Gastroenterology and Hepatology.
Douglas K. Rex, MD, of the division of gastroenterology and hepatology at Indiana University School of Medicine, and colleagues wrote that the ability of the Endocuff Vision (Olympus) device to expose the mucosa for inspection and increase polyp detection also helped reduce most of the work an endoscopist must perform during an examination.
“Video recording studies demonstrate that high-quality colonoscope withdrawal consists of careful inspection of the proximal sides of haustral folds, flexures and colorectal valves, removal of retained pools of debris and fluid, and adequate colonic distention,” they wrote. “Devices such as Endocuff can be used to hook and flatten haustral folds, improving mucosal exposure. However, an additional benefit of these devices is to make the process of examining between folds faster.”
Researchers randomly assigned patients to undergo screening or surveillance with the device (n = 101) or standard colonoscopy (n = 99). Two experienced endoscopists performed the colonoscopies and aimed for a thorough evaluation of the proximal side of all haustral folds, flexures and valves in the shortest amount of time. They measured withdrawal time with a stopwatch and subtracted washing, suctioning, polypectomy and biopsy times from the total time.
Investigators found that the mean inspection time was nearly 2 minutes shorter for the device group (6.5 minutes vs. 8.4 minutes; P < .0001).
The device also helped achieve a higher number of adenomas detected per colonoscopy (1.43 vs. 1.07; P = .07) and adenoma detection rate (61.4% vs. 52%; P = .21), as well as number of sessile serrated polyps (0.27 vs. 0.21; P = .12) and sessile serrated polyp detection rate (19.8% vs. 11.1%; P = .09).
Although some of the differences were not significant, Rex and colleagues wrote that if the study had a larger sample size, they might be able to demonstrate that the device is faster and improves detection.
“We and others have previously demonstrated in what are typically much larger studies, that when inspection times are forced to be equal, Endocuff results in statistically significant gains in detection,” they wrote. “The absolute reduction in overall mean withdrawal time with Endocuff Vision, including polypectomy and all washing and suctioning, was 1 minute, despite a one-third increase in the number of conventional adenomas and sessile serrated polyps removed in the Endocuff Vision arm.” – by Alex Young
Disclosures: Rex reports being a consultant for Olympus Corp. Please see the study for all other authors’ relevant financial disclosures.