High-definition colonoscopy versus Endocuff versus EndoRings versus full-spectrum endoscopy for adenoma detection at colonoscopy: a multicenter randomized trial - 16/07/18
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.)
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Abbreviations : ADR, APC, FUSE, HD
Plan
| DISCLOSURE: The following author received a gift for this study from the Indiana University Foundation from Scott Schurz of Bloomington, Indiana: D. K. Rex. In addition, the following authors disclosed financial relationships relevant to this publication: D. K. Rex: Research support recipient from Boston Scientific, Medivators, EndoChoice, EndoAid, Braintree Laboratories, Medtronic, Colonary Solutions, PAION, and US Endoscopy; consultant for Boston Scientific and Olympus. A. Repici, S. A. Gross: Consultant for Cook Medical, Boston Scientific, Olympus, and Medivators. C. Hassan: Research support: Endochoice, EndoAid, Norgine, and Fujifilm. All other authors disclosed no financial relationships relevant to this publication. |
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| See CME section; p. 397. |
Vol 88 - N° 2
P. 335 - août 2018 Retour au numéro
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