Second-generation distal attachment cuff improves adenoma detection rate: meta-analysis of randomized controlled trials - 12/02/21
Abstract |
Background and Aims |
Multiple randomized controlled trials (RCTs) using the second-generation distal attachment cuff device (Endocuff Vision; Olympus America, Center Valley, Pa, USA) have reported conflicting results in improving adenoma detection rate (ADR) compared with standard high-definition colonoscopy without the distal attachment. We conducted a systematic review and meta-analysis of RCTs to compare outcomes between second-generation cuff colonoscopy (CC) versus colonoscopy without the distal attachment (standard colonoscopy [SC]).
Methods |
An electronic literature search was performed using PubMed, Google Scholar, Embase, and Cochrane Library through May 2020. The primary outcome was reporting of ADR, and secondary outcomes were polyp detection rate (PDR), mean withdrawal time, mean adenomas per colonoscopy (APC), sessile serrated lesion detection rate, and adverse events. Pooled rates and risk ratios (RRs) with 95% confidence intervals were reported.
Results |
Eight RCTs with 5695 patients were included in the final analysis, with 2862 patients (mean age, 62.8 years; 52.9% men) in the CC group and 2833 patients (mean age, 62.6 years; 54.2% men) in the SC group. Compared with SC, use of CC was associated with a significant improvement in ADR (49.8% vs 45.6%, respectively; RR, 1.12; P = .02), PDR (58.1% vs 53%, respectively; RR, 1.12; P = .009), and APC (P < .01). Furthermore, use of CC had a .93-minute lower mean withdrawal time (P < .01) when compared with SC. The difference in ADR was larger in the screening/surveillance population (6.5%, P = .02) and when used by endoscopists with ADRs <30% (9.4%, P = .03).
Conclusions |
The results of this meta-analysis of randomized trials show a significant improvement in ADR and APC with shorter withdrawal times using the second-generation cuff device compared with SC.
Le texte complet de cet article est disponible en PDF.Abbreviations : ADR, APC, A-ADR, CC, FOBT+, D-ADR, NNT, PDR, P-ADR, RCT, RR, SC, SDR
Plan
| DISCLOSURE: The following authors disclosed financial relationships: D. Rex: Consultant for Olympus Corporation, Boston Scientific, Medtronic, Aries Pharmaceutical, Braintree Laboratories, Lumendi, Ltd, Norgine, Endokey, GI Supply, and Covidian/Medtronic; research support from Olympus Corporation, Medivators, Endoaid, and Erbe USA Ltd; ownership in Satisfai Health. P. Sharma: Consultant for Boston Scientific, Lumendi, Bausch, Medtronic, USA, and Olympus Corporation; research support from Olympus, US Endoscopy, Medtronic, Ironwood, Erbe USA Ltd, Docbot, Cosmo Pharmaceuticals, CDx, and Fujifilm; Equipment loan from Medtronic, Italy. All other authors disclosed no financial relationships. |
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| If you would like to chat with an author of this article, you may contact Dr Patel at patelhk.md@gmail.com. |
Vol 93 - N° 3
P. 544 - mars 2021 Retour au numéro
Article précédent
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