Impact of a ring-fitted cap on insertion time and adenoma detection: a randomized controlled trial

Rex, Douglas K.; Kessler, William R.; Sagi, Sashidhar; Rogers, Nicholas; Fischer, Monika; Bohm, Matthew; Wo, John M.; DeWitt, John M.; McHenry, Lee; Lahr, Rachel E.; Searight, Meghan P.; MacPhail, Margaret E.; Sullivan, Andrew W.; McWhinney, Connor D.; Vemulapalli, Krishna C.

doi:10.1016/j.gie.2019.06.042

Cited by 19 publications

(20 citation statements)

References 11 publications

(16 reference statements)

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“…Other sensitivity analyses restricted to high‐quality studies 16,20–22 and to RCTs with CRC screening as prevalent indication 21,22 confirmed the findings of the main analysis, with a consistent decrease in heterogeneity ( I 2 ranging from 14% to 38%; Table 2).…”

Section: Resultssupporting

confidence: 61%

“…Overall, based on five RCTs 16,20–23 (2751 patients), pooled ADR was 53.9% (95% CI 49–58.8%) with EndoRings and 49.1% (42–56.1%) with standard colonoscopy, and no significant difference was observed between the two add‐on devices, with a risk ratio of 1.05 (95% CI 0.95–1.17; Fig. 2).…”

Section: Resultsmentioning

confidence: 98%

“…From 56 unique studies identified using the search strategy, we included five RCTs 16,20–23 (Fig. 1) recruiting 2751 patients, of which 1370 were undergoing EndoRings‐assisted colonoscopy and 1381 standard HD colonoscopy.…”

Section: Resultsmentioning

confidence: 99%

“…CRC screening was the prevalent indication to colonoscopy in two trials, 21,22 and all the procedures were performed by experienced endoscopists, except for a single study 22 that included about 10% of procedures performed by trainees.…”

Section: Resultsmentioning

confidence: 99%

“…Results reported in the published trials seemed discordant, and some concerns on the uneasy use of EndoRings were raised in previous studies, mainly owing to the bulkier shape of this device that may increase the difficulty to pass the sigmoid colon 22 …”

Section: Discussionmentioning

confidence: 99%

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Impact of EndoRings on colon adenoma detection rate: A meta‐analysis of randomized trials

Facciorusso

Mohan

Crinò

et al. 2020

J of Gastro and Hepatol

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Background and Aim Evidence of a superior efficacy of EndoRings over standard colonoscopy in improving colon adenoma detection rate is lacking. We aimed to compare EndoRings and standard colonoscopy through a pairwise meta‐analysis of randomized trials. Methods We searched the PubMed/Medline and Embase database through July 2020 and identified five randomized controlled trials (recruiting 2751 patients). The primary outcome was adenoma detection rate; secondary outcomes included advanced and sessile serrated adenoma detection rate, mean adenoma per colonoscopy, cecal intubation rate, and time. We performed pairwise meta‐analysis through a random‐effects model and expressed data as risk ratio and 95% confidence interval. Results Overall, pooled adenoma detection rate was 53.9% (49–58.8%) with EndoRings and 49.1% (42–56.1%) with standard colonoscopy (risk ratio 1.05, 0.95–1.17). Advanced adenoma detection (risk ratio 0.91, 0.74–1.12), sessile serrated detection rate (risk ratio 1.10, 0.81–1.50), and polyp detection rate (risk ratio 1.06, 0.98–1.15) were similar between the two groups. Likewise, mean adenoma per colonoscopy (mean difference 0.17, −0.09 to 0.43), cecal intubation rate (risk ratio 1.00, 0.99–1.01), and cecal intubation time (mean difference 0.20 min, −0.34 to 0.74) did not differ between the two add‐on devices. No serious adverse event was observed. Conclusion EndoRings did not seem to significantly improve the diagnostic performance of colonoscopy. Further trials are needed to confirm these results.

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Section: Resultssupporting

confidence: 61%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of EndoRings on colon adenoma detection rate: A meta‐analysis of randomized trials

Facciorusso

Mohan

Crinò

et al. 2020

J of Gastro and Hepatol

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Detection of colorectal lesions during colonoscopy

2021

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Owing to its high mortality rate, the prevention of colorectal cancer is of particular importance. The resection of colorectal polyps is reported to drastically reduce colorectal cancer mortality, and examination by endoscopists who had a high adenoma detection rate was found to lower the risk of colorectal cancer, highlighting the importance of identifying lesions. Various devices, imaging techniques, and diagnostic tools aimed at reducing the rate of missed lesions have therefore been developed to improve detection. The distal attachments and devices for improving the endoscopic view angle are intended to help avoid missing blind spots such as folds and flexures in the colon, whereas the imaging techniques represented by image‐enhanced endoscopy contribute to improving lesion visibility. Recent advances in artificial intelligence‐supported detection systems are expected to supplement an endoscopist's eye through the instant diagnosis of the lesions displayed on the monitor. In this review, we provide an outline of each tool and assess its impact on the reduction in the incidence of missed colorectal polyps by summarizing previous clinical research and meta‐analyses. Although useful, the many devices, image‐enhanced endoscopy, and artificial intelligence tools exhibited various limitations. Integrating these tools can improve their shortcomings. Combining artificial intelligence‐based diagnoses with wide‐angle image‐enhanced endoscopy may be particularly useful. Thus, we hope that such tools will be available in the near future.

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The Use of Attachment Devices to Aid in Adenoma Detection

Lawrence

Gross²

2020

Curr Treat Options Gastro

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Impact of a ring-fitted cap on insertion time and adenoma detection: a randomized controlled trial

Cited by 19 publications

References 11 publications

Impact of EndoRings on colon adenoma detection rate: A meta‐analysis of randomized trials

Impact of EndoRings on colon adenoma detection rate: A meta‐analysis of randomized trials

Detection of colorectal lesions during colonoscopy

The Use of Attachment Devices to Aid in Adenoma Detection

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