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Endocuff-assisted versus standard colonoscopy for improving adenoma detection rate: meta-analysis of randomized controlled trials

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Abstract

Background

The effect of Endocuff-assisted colonoscopy compared with standard colonoscopy is conflicting in terms of the adenoma detection rate. The aim of this meta-analysis was to compare the efficacy of Endocuff-assisted colonoscopy for adenoma detection.

Methods

PubMed, Embase, Google Scholar and Cochrane Library were searched up to the end of June 8, 2021. All randomized controlled trials (RCTs) comparing Endocuff-assisted colonoscopy with standard colonoscopy were included. Dichotomous data were pooled to obtain the relative risk with a 95% CI, whereas continuous data were pooled using a mean difference with 95% CI.

Results

A total of 23 RCTs involving 17,999 patients were included. Compared with standard colonoscopy, use of the Endocuff was associated with a significant improvement in the adenoma detection rate (RR = 1.16, 95% CI 1.08–1.24), polyp detection rate (RR = 1.17, 95% CI 1.09–1.25), sessile serrated lesion detection rate (RR = 1.23, 95% CI 1.05–1.43), left-side lesion detection rate (RR = 1.24, 95% CI 1.08–1.43), and mean number of adenomas per patient (MD = 0.17, 95% CI 0.08–0.26). There were no significant differences between the and groups in detection of advanced adenomas, mean number of polyps per patient, right-side lesion detection rate, cecal intubation rate, cecal intubation time and withdrawal time.

Conclusions

The pooled evidence suggests a significant improvement in the adenoma detection rate, and polyp detection rate using the Endocuff. On the other hand, no significant effect on the detection of advanced adenomas and mean number of polyps per patient was noted.

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Author notes

  1. Jun Wang, Chuncui Ye contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, 221002, Jiangsu, People’s Republic of China

    J. Wang, C. Ye & S. Fei

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Corresponding author

Correspondence to S. Fei.

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Jun Wang, Chuncui Ye, and Sujuan Fei have no conflicts of interest or financial ties to disclose.

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Supplementary Information

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Supplementary file1 (DOCX 17 KB)

10151_2022_2642_MOESM2_ESM.docx

Supplementary file2 Supplementary Fig. 1. Cochrane collaboration’s risk of bias assessment of included studies. Supplementary Fig. 2. Begg’s funnel plot for publication bias. Supplementary Fig. 3. Forest plots comparing endoscopic-assisted and standard colonoscopy in terms of advanced ADR. ADR = adenoma detection rate. Supplementary Fig. 4. Forest plots comparing endoscopic-assisted and standard colonoscopy in terms of adverse events. Supplementary Fig. 5. Forest plots comparing endoscopic-assisted and standard colonoscopy in terms of ileum intubation rate. (DOCX 3119 KB)

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Wang, J., Ye, C. & Fei, S. Endocuff-assisted versus standard colonoscopy for improving adenoma detection rate: meta-analysis of randomized controlled trials. Tech Coloproctol 27, 91–101 (2023). https://doi.org/10.1007/s10151-022-02642-9

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