Effect of a distal attachment cuff on the adenoma detection rate in screening colonoscopy: a randomized controlled trial in the Spanish population

Background and study aims: Endocuff Vision™ (EV) is a disposable device designed to improve polyp detection. The primary aim of this study was to evaluate the effect of EV on the adenoma detection rate (ADR) and mean number of adenomas per patient (MAP). Patients and methods: This multicenter randomized controlled trial compared EV-assisted colonoscopy (EAC) and standard colonoscopy (SC). Patients were referred due to a positive fecal immunochemical test (FIT) in a bowel cancer screening program (BCSP), direct screening colonoscopy without prior FIT, surveillance colonoscopy, or family history of colorectal cancer. Results: In total, 1437 patients (55.9% male; median age, 59 years) were randomized at eight Spanish university hospitals. No significant differences were found in either the ADR (EAC vs. SC, 55.8% vs. 54.3%; P = 0.576) or the MAP (1.60 vs. 1.35; P = 0.03). Compared with SC, EAC was not associated with a significant improvement in the detection rates of advanced adenomas, sessile serrated lesions, or advanced sessile serrated lesions. There was no difference in the cecal intubation rate but the successful ileal intubation rate, among patients in whom it was attempted, was lower with EAC (64.3% vs. 86.5% with SC; P = 0.001). Conclusions: EV did not improve either the ADR or the MAP. EV may increase the difficulty of ileal intubation whenever it is attempted.

Publikationsverlauf

Eingereicht: 17. Oktober 2024

Angenommen nach Revision: 28. Mai 2025

Accepted Manuscript online:
02. Juni 2025