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Updated: Jan 31, 2026

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水交換と遠位キャップ（複数可）併用下での腺腫検出率向上に関する前向き国際多施設共同無作為化比較試験

Felix W Leung^1,2,3, Sergio Cadoni⁴, Long Chen⁵

¹Gastroenterology, Medicine, Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System, North Hills, CA, USA (Felix W. Leung, Vivek Dixit, Nora Jamgotchian, Hui Jia).

Annals of gastroenterology

|January 30, 2026

要旨

Background:

Interval cancers are linked to a low adenoma detection rate (ADR), prompting calls for benchmark-guided ADR performance improvement. Although water exchange and a straight cap (CAP) have been reported to independently improve ADR, the effects of Daisycuff^™ and Endocuff Vision^® remained unknown. We hypothesized that selected cap(s) could increase ADR and related water exchange outcomes.

Methods:

Subjects were randomized to No cap, or CAP, Daisycuff^™ and Endocuff Vision^® at 7, 5 and 2 sites. The primary outcome was ADR. Outcomes were compared for No cap vs. the above randomized caps.

Results:

Demographic and historic data revealed adequate randomization. Despite variations in site-specific pretrial ADR, the aggregated data showed that the ADR of No cap (45.6%) exceeded the latest benchmark (35%). Each added cap increased the ADR, and the difference using Daisycuff^™(52.8%) approached statistical significance (P=0.05). In the right colon, CAP and Daisycuff^™ significantly increased ADR. In the left colon, Daisycuff^™ significantly increased adenoma per colonoscopy. Factors that improved adenoma detection were consistent with published reports. Detection rates based on site, indication, sedation type, polyp size, shape and pathology in the No cap group were consistent with conventional data and were not influenced by the caps.

Conclusions:

The significantly higher right-colon ADRs with CAP and Daisycuff^™ suggest potential clinical relevance for reducing interval cancers. Although water exchange with or without caps yields ADRs that surpass the benchmark, the positive findings for selected cap(s) need to be confirmed in order to enhance the options for further improvement of water exchange.

キーワード:

水交換結腸鏡検査腺腫検出率遠位キャップ

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