RT Journal Article
SR Electronic
T1 Adenoma detection by Endocuff-assisted versus standard colonoscopy in routine practice: a cluster-randomised crossover trial
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP gutjnl-2019-319565
DO 10.1136/gutjnl-2019-319565
A1 David Karsenti
A1 Gaelle Tharsis
A1 Bastien Perrot
A1 Philippe Cattan
A1 Gilles Tordjman
A1 Franck Venezia
A1 Elie Zrihen
A1 Dominique Gillot
A1 Agnes Gillet
A1 Charles Hagege
A1 Joelle Samama
A1 Isabelle Etienney
A1 Jean-Philippe Lab
A1 Bernard Guigui
A1 Jacqueline Zago
A1 Bouchra Benkessou
A1 Pascal Burtin
A1 Maryan Cavicchi
YR 2020
UL http://gut.bmj.com/content/early/2020/03/24/gutjnl-2019-319565.abstract
AB Objective Endocuff Vision (ECV) is the second generation of a device designed to improve polyp detection. The aim of this study was to evaluate its impact on adenoma detection rate (ADR) in routine colonoscopy.Design This cluster-randomised crossover trial compared Endocuff-assisted (ECV+) with standard (ECV-) colonoscopy. Two teams of 11 endoscopists each with prior ECV experience, balanced in terms of basal ADR, gender and case volume were compared. In randomised fashion, the teams started with ECV+ or ECV- and switched group after inclusion of half of the cases. The main outcome criterion was ADR difference between ECV+ and ECV-. Subgroup analysis was done for physicians with low and high ADR (< or ≥ 25%).Results During two periods of 20 and 21 weeks, respectively, the 22 endoscopists included 2058 patients (1032 ECV- vs 1026 ECV+, both groups being comparable). Overall ADR for both groups taken together was higher with ECV (39.2%) than without (29.4%; p<0.001) irrespective of the sequence of use (ECV+ or ECV- first), but mostly in adenomas <1 cm. In the physician subgroup analysis, only high detectors showed a significant ADR increase (from 31% to 41%, p<0.001), while the increase in the low detectors was not significant (from 24% to 30%, p=0.11). ECV had a positive impact in all colonic locations, except for the rectum. No ECV- related complication was reported.Conclusion We observed a significant ADR difference of approximately 10% by the use of ECV. By subgroup analysis, this increase was significant only in physicians classified as high detectors.Trial registration number ClinicalTrials.gov (NCT03344055).