Meta-analysis Finds Endocuff and Cap Equal for Detection
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Meta-analysis Finds Endocuff and Cap Equal for Detection

Douglas K. Rex, MD, MASGE, reviewing Li A, et al. J Gastroenterol Hepatol 2020 Jun 19.

Six randomized controlled trials comparing Endocuff (Endocuff Vision in one trial and the original Endocuff in the other 5) versus short distal cap (cap-assisted colonoscopy [CAC]) in 1994 patients were identified. The adenoma detection rate was 47% in the Endocuff-assisted colonoscopy (EAC) group versus 45.1% in the CAC group (P=.33). EAC improved the detection rate of diminutive adenomas and polyps, but not small or large adenomas, compared to CAC. The cecal intubation rate was reduced from 97.9% with CAC to 96.5% with EAC (P=.04), but cecal intubation time and withdrawal time were not different.

Douglas K. Rex, MD, FASGE

COMMENT

This result was unexpected given that meta-analyses suggest a clearer improvement with EAC compared to standard colonoscopy than is seen with CAC. My own experience is that EAC is a superior device for improving cecal intubation speed, reducing withdrawal time, and finding hidden polyps. However, the greater percentage of patients in which the sigmoid can’t be passed with EAC compared to CAC is very consistent with everyday experience.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Li A, Yang JZ, Yang, XX, et al. Endocuff-assisted colonoscopy versus cap-assisted colonoscopy for adenoma detection rate: a meta-analysis of randomized controlled trials. J Gastroenterol Hepatol 2020 Jun 19. (Epub ahead of print) (https://doi.org/10.1111/jgh.15155)

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