Efficacy of Endocuff Vision-assisted colonoscopy in improving adenoma detection rate: an updated systematic review...

Colorectal cancer (CRC) poses a significant health challenge, being a leading cause of cancer-related mortality in the United States. Despite the effectiveness of colonoscopy in early detection and prevention, a substantial number of adenomas remain undetected, contributing to interval CRC cases. This systematic review and meta-analysis evaluate the efficacy of Endocuff Vision (ECV), an advanced colonoscopy attachment, compared to standard colonoscopy (SC) in enhancing adenoma detection rates (ADR) and other relevant outcomes.

Systematic search was performed in PubMed, Web of Science, Scopus, and Embase from inception to June 2025. Risk of bias assesment was performed by using ROB2. Data-analysis was conducted using R version 4.2.2 (2022-10-31) and RStudio version 2022.07.2 (2009-2022, RStudio, Inc.).

We included 18 randomized controlled trials involving 17,734 patients. ECV significantly improves ADR (RR: 1.13, 95% CI: 1.07-1.20; p < 0.0001), advanced adenoma detection rate (AADR) (RR: 1.11, 95% CI: 1.01-1.21; p = 0.0282), polyp detection rate (PDR), sessile serrated lesion detection rate (SLDR), and left side lesion detection rate (LSLDR), while also reducing withdrawal and cecal intubation times. Subgroup analyses suggest that ECV is particularly beneficial in screening and surveillance populations. However, evidence quality varied, with some outcomes exhibiting moderate certainty.

Our results underscore ECV's potential as a valuable tool in CRC screening, aiming to enhance detection rates and ultimately reduce interval cancer risks. Future research should focus on long-term clinical implications, cost-effectiveness, and comparative studies with other detection-enhancing technologies to further substantiate ECV's role in clinical practice.