ENDOCUFF VISION ASSISTED VERSUS STANDARD POLYP RESECTION IN THE COLORECTUM: A PROSPECTIVE RANDOMIZED STUDY (EVASTA STUDY)

Aims:

Cap assisted colonoscopy (CAC) is frequently used in order to facilitate adenoma detection during endoscopy. However, data on how cap assistance influences resection of polyps is scarce. We aimed to evaluate the impact of a cap assistance (Endocuff vision device, EVD) on the resection time of colorectal polyps in patients undergoing routine colonoscopy.

Methods:

A randomized, prospective trial in a university hospital in Germany was performed. A total of 250 patients were randomly assigned 1:1 to receive either a colonscopy with the EVD (EVD arm) or standard colonoscopy without the use of a cap (standard arm). Primary outcome was duration of polypectomy. Secondary outcomes were adenoma detection rate, cecum and ileum intubation time, procedural complications, patient satisfaction, and propofol dosage.

Results:

The usage of an EVD led to a significant reduction of the polypectomy time (81 vs. 54 seconds in standard vs. EVD arm; p = 0.001). The polyp and adenoma detection rate did not differ between both study groups. Endocuff assistance also resulted in a shorter cecum intubation time compared to the standard group (7.4 vs. 9.6 minutes; p = 0.04). In contrast, no difference in withdrawal time or total colonoscopy duration was observed.

Conclusions:

Endocuff vision assisted colonoscopy reduces duration of polypectomy. The observed effect is assuemd to be due to stable scope positions during resection. Further studies should investigate whether comparable effects can be considered with respect to other interventions such as clipping or biopsy sampling.