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Gastrointest Endosc. 2018 Aug;88(2):335-344.e2. doi: 10.1016/j.gie.2018.02.043. Epub 2018 Mar 9.

High-definition colonoscopy versus Endocuff versus EndoRings versus full-spectrum endoscopy for adenoma detection at colonoscopy: a multicenter randomized trial.

Author information

1
Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
2
Department of Gastroenterology, Humanitas Research Hospital & Humanitas University via Manzoni, Milan, Italy.
3
Department of Gastroenterology, Tisch Hospital, NYU Langone Medical Center, New York, New York, USA.
4
Department of Gastroenterology, Nuovo Regina Margherita Hospital, Rome, Italy.
5
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
6
Department of Public Health and Preventative Medicine, St. George's University, Grenada, West Indies.

Abstract

BACKGROUND AND AIMS:

Devices used to improve polyp detection during colonoscopy have seldom been compared with each other.

METHODS:

We performed a 3-center prospective randomized trial comparing high-definition (HD) forward-viewing colonoscopy alone to HD with Endocuff to HD with EndoRings to the full spectrum endoscopy (FUSE) system. Patients were age ≥50 years and had routine indications and intact colons. The study colonoscopists were all proven high-level detectors. The primary endpoint was adenomas per colonoscopy (APC).

RESULTS:

Among 1188 patients who completed the study, APC with Endocuff (APC mean ± standard deviation: 1.82 ± 2.58), EndoRings (1.55 ± 2.42), and standard HD colonoscopy (1.53 ± 2.33) were all higher than FUSE (1.30 ± 1.96; P < .001 for APC). The APC for Endocuff was higher than standard HD colonoscopy (P = .014). Mean cecal insertion times with FUSE (468 ± 311 seconds) and EndoRings (403 ± 263 seconds) were both longer than with Endocuff (354 ± 216 seconds; P = .006 and .018, respectively).

CONCLUSIONS:

For high-level detectors at colonoscopy, forward-viewing HD instruments dominate the FUSE system, indicating that for these examiners image resolution trumps angle of view. Further, Endocuff is a dominant strategy over EndoRings and no mucosal exposure device on a forward-viewing HD colonoscope. (Clinical trial registration number: NCT02345889.).

PMID:
29530353
DOI:
10.1016/j.gie.2018.02.043
[Indexed for MEDLINE]

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