Second-generation device improves colorectal adenoma detection

Reuters Health Information: Second-generation device improves colorectal adenoma detection

Second-generation device improves colorectal adenoma detection

Last Updated: 2018-02-07

By Will Boggs MD

NEW YORK (Reuters Health) - Colonoscopy using the second-generation Endocuff Vision (EV) is associated with improved adenoma-detection rates, according to results from the ADENOMA trial.

"Most interesting was the 10.8% increase in adenoma-detection rate in fecal-occult-blood-positive screening patients - that is a huge increase," Dr. Colin J. Rees from South Tyneside District Hospital, South Shields, and Newcastle University, Newcastle, UK, told Reuters Health by email.

Adenoma-detection rate (ADR) is the most important marker of colonoscopy quality. EV, a device mounted onto the distal tip of a colonoscope, is designed to enhance mucosal visualization by holding back colonic folds during withdrawal.

Dr. Rees and colleagues from one academic and six community hospitals compared ADR between EV-assisted colonoscopy and standard colonoscopy in their randomized trial of 1,772 patients (mean age, 62).

ADR was significantly higher with EV-assisted colonoscopy (40.9%) than with standard colonoscopy (36.2%), according to the report, online January 23 in Gut.

Polyps were detected at significantly higher frequency with EV-assisted colonoscopy (54.1%) than with standard colonoscopy (48%), as were colorectal cancers (4.1% vs. 2.3%).

These differences were driven largely by colonoscopists who performed colonoscopy on patients who were positive for fecal occult blood as part of the English Bowel Cancer Screening Program.

EV cuff removal was necessary in 4.1% of patients, but there were no adverse events related to its use.

Median insertion time to the cecum was eight minutes with the device and nine minutes with standard colonoscopy, and there was no difference in withdrawal times for procedures without polyps.

When asked specifically, 8.6% of patients found anal intubation more uncomfortable with EV than without, but no other measures of comfort differed significantly between the colonoscopy groups.

"Improved mucosal visualization is crucial to high-quality colonoscopy," Dr. Rees said. "This trial provides strong evidence that Endocuff Vision improves that visualization, and its routine use should be considered."

Dr. Rees has received research grants from ARC Medical, which manufactures the EV device and funded the trial.


Gut 2018.

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