High-Definition Colonoscopy Compared With Cuff- and Cap-Assisted Colonoscopy: Results From a Multicenter,...

Area of Science:

• Gastroenterology
• Endoscopy
• Clinical Trials

Background:

• Distal attachment devices (cuff and cap) for colonoscopy aim to improve adenoma detection rates (ADR).
• Previous studies on these devices have yielded variable results when compared to high-definition white light colonoscopy (HDWLE).

Purpose of the Study:

• To compare the efficacy of HDWLE with two types of distal attachments (cuff and cap) in detecting colorectal adenomas.
• To evaluate secondary outcomes including adenoma detection, lesion characterization, and procedural efficiency.

Main Methods:

• A prospective, multicenter randomized controlled trial involving 1203 patients undergoing screening or surveillance colonoscopy.
• Comparison of HDWLE against Endocuff Vision (CF) and Reveal (CP) distal attachments.
• Primary outcome was adenoma detection rate (ADR); secondary outcomes included adenomas per colonoscopy, advanced adenoma, sessile serrated lesion detection, and withdrawal time.

Main Results:

• No significant differences in ADR, adenomas per colonoscopy, advanced adenoma, sessile serrated lesion detection, or right-sided ADR were observed among the three groups (HDWLE, CF, CP).
• The cuff (CF) group showed a significantly higher number of polyps per colonoscopy compared to HDWLE and CP.
• In screening patients, the CF group detected more neoplasms per colonoscopy with a shorter withdrawal time.

Conclusions:

• Distal attachment devices (cuff and cap) did not demonstrate a significant benefit over HDWLE for ADR in this trial, particularly for experienced endoscopists.
• The Endocuff (CF) may show a potential advantage in detecting neoplasms within the screening population.