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

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.

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.

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.

EndoRings did not seem to significantly improve the diagnostic performance of colonoscopy. Further trials are needed to confirm these results.