1008 Higher Adenoma Detection Rate With Endocuff: A Randomized Controlled Trial

Comparative Efficacy of Colonoscope Distal Attachment Devices in Increasing Rates of Adenoma Detection: A Network Meta-analysis

“…All 25 RCTs were 2-arm controlled trials, in which 14 compared Cap-assisted colonoscopy with SC, 21-34 9 compared Endocuff with SC, 35-43 1 compared Endorings with SC, 44 and 1 compared Endocuff with Cap. 45 The PDR was reported in all included trials, the ADR was registered in 20 RCTs, 22,[24][25][26][28][29][30]32,33,[35][36][37][38][39][40][41][42][43][44][45] the cecal intubation rate in 16 RCTs, 22,23,[25][26][27][28][29][30][31][32][33][34]37,40,43,45 and cecal intubation time in 17 RCTs. [21][22][23][24][25][26][28][29][30]32,34,…”

“…21,23,26,27,31,33,34 Quality assessment was performed in the context of the primary outcome, and overall the studies were believed to be at moderate risk of bias, mainly owing to performance and detection bias related to the unblinded design of the included RCTs. Six abstracts 35,36,38,41,42,45 and 5 full-text reports 21,23,27,31,34 were considered at higher risk of bias because of incomplete outcome reporting. Overall and study-level quality assessments are summarized in Supplementary Figure 1A and B, respectively.…”

“…Pairwise meta-analysis. Overall, based on 20 RCTs 22,[24][25][26][28][29][30]32,33,[35][36][37][38][39][40][41][42][43][44][45] (14,293 patients), distal attachment devices showed increased rates of adenoma detection as compared with SC (39.3% vs 35.1%; RR, 1.13; 95% CI, 1.03-1.23; P ¼ .007; I 2 ¼ 75%) ( Supplementary Figure 2). This would translate into a potential absolute increase in ADR to 11.3% and 45.2% Figure 3).…”

“…RCTs [21][22][23][24][25][26][28][29][30]32,34,35,39,41,[43][44][45] enrolling 11,097 patients reported data on the comparison of cecal intubation time between add-on devices and SC. Distal attachment devices lead to significantly shorter cecal intubation times as compared with SC (mean difference, -0.71; -0.33 to -1.09; P < .001), with considerable heterogeneity (I 2 ¼ 89%).…”

“…(B) Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. 16% patients with "more than two episodes of discomfort" 21% patients with "more than two episodes of discomfort" 1 postpolypectomy bleeding and 1 perforation 30 Not reported Not reported Prachayakul, 2012 31 Not reported Not reported Rastogi 2011 32 None None Takeuchi 2010 33 Minor bleeding in 3 patients Minor bleeding in 1 patient Tee 2010 34 Minor bleeding in 1 patient Minor bleeding in 1 patient Endocuff vs standard colonoscopy Ngu 2017 35 Procedure uncomfortable in 23.6% patients vs 15.0% Procedure uncomfortable in 15% patients Bhattacharyya 2016 36 None None Biecker 2015 37 None None Catalano 2017 38 Not reported Not reported De Palma 2017 39 Minor bleeding in 7 (2.5%) patients None Floer 2014 40 None None Garcia 2016 41 None None Hass 2016 42 Minor bleeding in 8.3% of patients None Van Doorn 2017 43 A case of deep venous thrombosis Minor bleeding in 2 patients A case of perianal abscess Endorings vs standard colonoscopy Dik 2015 44 None None Endocuff vs Cap Yamaoka 2017 45 Not reported Not reported…”