Efficacy of Endocuff Vision compared to first-generation Endocuff in adenoma detection rate and polyp detection rate in high-definition colonoscopy: a systematic review and network meta-analysis

Muhammad Aziz; Hossein Haghbin; Manesh Kumar Gangwani; Sachit Sharma; Yusuf Nawras; Zubair Khan; Saurabh Chandan; Babu P Mohan; Wade Lee-Smith; Ali Nawras

doi:10.1055/a-1293-7327

Efficacy of Endocuff Vision compared to first-generation Endocuff in adenoma detection rate and polyp detection rate in high-definition colonoscopy: a systematic review and network meta-analysis

Endosc Int Open. 2021 Jan;9(1):E41-E50. doi: 10.1055/a-1293-7327. Epub 2021 Jan 1.

Authors

Affiliations

¹ Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, Ohio, United States.
² Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, United States.
³ Department of Internal Medicine, Mercy Hospital St. Louis, St. louis, Missouri, 63141.
⁴ Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, Ohio, United States.
⁵ Department of Gastroenterology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States.
⁶ Division of Gastroenterology and Hepatology, CHI Creighton University Medical Center, Omaha, Nebraska, United States.
⁷ Divison of Gastroenterology and Hepatology, University of Utah Healthcare, Salt Lake City, Utah, United States.
⁸ University of Toledo Libraries, University of Toledo Medical Center, Toledo, Ohio, United States.

Abstract

Background and study aims Recently, the newer Endocuff Vision (ECV) has been evaluated for improving colonoscopy outcome metrics such as adenoma detection rate (ADR) and polyp detection rate (PDR). Due to lack of direct comparative studies between ECV and original Endocuff (ECU), we performed a systematic review and network meta-analysis to evaluate these outcomes. Methods The following databases were searched: PubMed, Embase, Cochrane, and Web of Sciences to include randomized controlled trials (RCTs) comparing ECV or ECU colonoscopy to high-definition (HD) colonoscopy. Direct as well as network meta-analyses comparing ADR and PDR were performed using a random effects model. Relative-risk (RR) with 95 % confidence interval (CI) was calculated. Results A total of 12 RCTs with 8638 patients were included in the final analysis. On direct meta-analysis, ECV did not demonstrate statistically improved ADR compared to HD colonoscopy (RR: 1.12, 95 % CI 0.99-1.27). A clinically and statistically improved PDR was noted for ECV compared to HD (RR: 1.15, 95 % CI 1.03-1.28) and ECU compared to HD (RR: 1.26, 95 % CI 1.09-1.46) as well as improved ADR (RR: 1.22, 95 % CI 1.05-1.43) was observed for ECU colonoscopy when compared to HD colonoscopy. These results were also consistent on network meta-analysis. Lower overall complication rates (RR: 0.14, 95 % CI 0.02-0.84) and particularly lacerations/erosions (RR: 0.11, 95 % CI 0.02-0.70) were noted with ECV compared to ECU colonoscopy. Conclusions Although safe, the newer ECV did not significantly improve ADR compared to ECU and HD colonoscopy. Further device modification is needed to increase the overall ADR and PDR.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Publication types

Review