Endoscopy 2019; 51(07): 637-645
DOI: 10.1055/a-0925-4956
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endocuff-assisted colonoscopy for surveillance of serrated polyposis syndrome: a multicenter randomized controlled trial

Liseth Rivero-Sánchez
1  Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Center for Biomedical Research in the Hepatic and Digestive Diseases Network (CIBERehd), Barcelona, Spain
,
Jorge López Vicente
2  Hospital Universitario de Móstoles, Digestive System Service, Móstoles, Spain
,
Luis Hernandez Villalba
3  Hospital Santos Reyes, Digestive System Service, Aranda de Duero, Spain
,
Ignasi Puig
4  Althaia, Xarxa Assistencial Universitària de Manresa, Digestive System Service, Manresa, Spain
,
Coral Arnau-Collell
5  Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
Lorena Moreno
5  Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
Mireia Díaz
5  Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
Cristina Rodriguez de Miguel
6  Hospital Clinic de Barcelona, Digestive Endoscopy Unit, Barcelona, Spain
,
Teresa Ocaña
7  Hospital Clinic de Barcelona, Department of Gastroenterology, Barcelona, Spain
,
Leticia Moreira
1  Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Center for Biomedical Research in the Hepatic and Digestive Diseases Network (CIBERehd), Barcelona, Spain
,
Miriam Cuatrecasas
8  Hospital Clinic de Barcelona, Department of Pathology, Barcelona, Spain
,
Sabela Carballal
1  Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Center for Biomedical Research in the Hepatic and Digestive Diseases Network (CIBERehd), Barcelona, Spain
,
Ariadna Sánchez
1  Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Center for Biomedical Research in the Hepatic and Digestive Diseases Network (CIBERehd), Barcelona, Spain
,
Oswaldo Ortiz
7  Hospital Clinic de Barcelona, Department of Gastroenterology, Barcelona, Spain
,
Josep Llach
6  Hospital Clinic de Barcelona, Digestive Endoscopy Unit, Barcelona, Spain
,
Francesc Balaguer
1  Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Center for Biomedical Research in the Hepatic and Digestive Diseases Network (CIBERehd), Barcelona, Spain
,
María Pellisé
1  Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Center for Biomedical Research in the Hepatic and Digestive Diseases Network (CIBERehd), Barcelona, Spain
,
on behalf of the EndoCAR group from the Spanish Gastroenterology Association and the Spanish Society of Digestive Endoscopy› Author Affiliations
TRIAL REGISTRATION: Multicenter, prospective, randomized, controlled and parallel study NCT02592603 at clinicaltrials.gov
Further Information

Publication History

submitted: 08 October 2018

accepted after revision: 07 March 2019

Publication Date:
07 June 2019 (eFirst)

Abstract

Background and study aims Serrated polyposis syndrome (SPS) is a condition with high risk for colorectal cancer. The Endocuff device has been shown to increase adenoma detection in the general and screening population. We aimed to ascertain whether Endocuff-assisted colonoscopy increases detection of serrated lesions in comparison with standard colonoscopy during the surveillance of patients with SPS. 

Methods In a multicenter randomized controlled study, patients who met SPS criteria I and/or III under surveillance (previous resection of all serrated lesions ≥ 4 mm) were consecutively randomly allocated 1:1 to Endocuff-assisted colonoscopy or standard colonoscopy, performed by expert endoscopists. The main outcome was the mean number of serrated lesions detected per patient.

Results 122 patients (standard colonoscopy n = 60; Endocuff-assisted colonoscopy n = 62; 59 % men; mean age 60.6 (standard deviation [SD] 7.5) were included at 4 centers. Baseline variables (demographic data, SPS phenotype, colorectal cancer [CRC] history, cumulative polyps, and follow-up), cecal intubation rate, and withdrawal time were similar between groups. There was no statistically significant difference between Endocuff-assisted colonoscopy and standard colonoscopy for the mean number of serrated lesions detected per patient: 5.8 (95 % confidence interval [95 %CI] 4.4 – 7.2) and 5.0 (3.9 – 6.1), respectively (P = 0.36). There were also no differences between Endocuff-assisted and standard colonoscopy for detection of sessile serrated lesions (mean number per patient 2.5 [1.3 – 3.6] vs. 2.0 [1.1 – 3.0], P = 0.54) and adenomas (0.9 [0.5 – 1.3] vs. 0.5 [0.3 – 0.7], P = 0.12).

Conclusion Use of Endocuff-assisted colonoscopy did not significantly increase the number of serrated lesion detected per patient during surveillance of SPS.