Chin M, Karnes W, Jamal MM, Lee JG, Lee R, Samarasena J, Bechtold ML, Nguyen DL. Use of the Endocuff during routine colonoscopy examination improves adenoma detection: A meta-analysis. World J Gastroenterol 2016; 22(43): 9642-9649 [PMID: 27920485 DOI: 10.3748/wjg.v22.i43.9642]
Corresponding Author of This Article
Douglas L Nguyen, MD, Division of Gastroenterology and Hepatology, University of California Irvine, Department of Medicine, 101 The City Drive, Orange, CA 92868, United States. douglaln@uci.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 21, 2016; 22(43): 9642-9649 Published online Nov 21, 2016. doi: 10.3748/wjg.v22.i43.9642
Use of the Endocuff during routine colonoscopy examination improves adenoma detection: A meta-analysis
Matthew Chin, William Karnes, M Mazen Jamal, John G Lee, Robert Lee, Jason Samarasena, Matthew L Bechtold, Douglas L Nguyen
Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States
M Mazen Jamal, Division of Gastroenterology, Long Beach Veterans Affairs Health System, Long Beach, CA 90822, United States
Matthew L Bechtold, Division of Gastroenterology, University of Missouri Health, Columbia, MO 65201, United States
Author contributions: Chin M and Nguyen DL contributed to conception, design and acquisition of data; Chin M, Bechtold ML and Nguyen DL contributed to analysis and interpretation of data; Chin M, Karnes W, Lee JG, Lee R, Samarasena J, Bechtold ML and Nguyen DL contributed to drafting of manuscript; Chin M, Karnes W, Lee JG, Lee R, Samarasena J, Bechtold ML and Nguyen DL contributed to critical revision of manuscript; Jamal MM, Bechtold ML and Nguyen DL were statistical expertise.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Douglas L Nguyen, MD, Division of Gastroenterology and Hepatology, University of California Irvine, Department of Medicine, 101 The City Drive, Orange, CA 92868, United States. douglaln@uci.edu
Telephone: +1-949-8245011
Received: July 22, 2016 Peer-review started: July 25, 2016 First decision: September 12, 2016 Revised: September 24, 2016 Accepted: October 19, 2016 Article in press: October 19, 2016 Published online: November 21, 2016 Processing time: 119 Days and 1.8 Hours
Abstract
AIM
To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy.
METHODS
Scopus, Cochrane databases, MEDLINE/PubMed, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meeting were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy (EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerSimonian and Laird models with the odds ratio (OR) to assess adenoma detection, cecal intubation rate, and complications performed.
RESULTS
Nine studies (n = 5624 patients) were included in the analysis. Compared to standard colonoscopy, procedures performed with EC had higher frequencies for adenoma (OR = 1.49, 95%CI: 1.23-1.80; P = 0.03), and sessile serrated adenomas detection (OR = 2.34 95%CI: 1.63-3.36; P < 0.001). There was no significant difference in cecal intubation rates between the EAC group and standard colonoscopy (OR = 1.26, 95%CI: 0.70-2.27, I2 = 0%; P = 0.44). EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency for perforation.
CONCLUSION
The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy.
Core tip: Our meta-analysis of more than 5000 patients demonstrates that when compared to traditional colonoscopy, the use of an Endocuff device improves adenoma detection rates without any adverse effect on procedural efficiency or increased risk of significant adverse events.
