Conventional colonoscopy vs. cap-assisted colonoscopy: there are differences in colonoscopy performance?
DOI:
https://doi.org/10.47892/rgp.2024.443.1674Keywords:
Colonoscopy, Adenoma, Diagnosis, Procedure, surgical, PolypsAbstract
Introduction: Colonoscopy is the standard method for colorectal cancer diagnosis. Despite the use of multiple devices, polyp and adenoma detection results have been inconsistent. Objectives: The main aim of this research is to determine if there have been differences between conventional colonoscopy (CC) and cap-assisted colonoscopy (CAC) in the diagnosis performance to detect adenomas. Materials and methods: This is a prospective randomized clinical trial that compares the diagnostic performance of CC and CAC in detecting adenomas in a public reference hospital. Results: We randomly assigned 131 patients to either CC (n=64) or CAC (n=67). Cap-assisted colonoscopy was associated with shorter cecal intubation times (6 min vs. 7,5 min, p=0.005) and a higher chance of intubating the ileum (RR = 1.62; 1.21-2.17). There was no statistical difference in the adenoma detection rates (RR: 1.62; 1.21-2.17) or polyp detection rates (RR: 1.07; 0.602-1.919) between CC and CAC. Conclusion: Cap-assisted colonoscopy was associated with a shorter duration of cecal intubation and a higher probability of ileum intubation. We did not find statistical differences in the adenoma detection rates. In the CAC arm, there was a trend to detect more adenoma in the right colon, although this difference was not statistically significant.
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Araghi M, Soerjomataram I, Jenkins M, Brierley J, Morris E, Bray F, et al. Global trends in colorectal cancer mortality: projections to the year 2035. Int J Cancer. 2019;144(12):2992-3000. doi: 10.1002/ijc.32055.
Rex DK, Rahmani EY, Haseman JH, Lemmel GT, Kaster S, Buckley JS. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology. 1997;112(1):17-23. doi: 10.1016/s0016-5085(97)70213-0.
Winawer SJ, Zauber AG, O'Brien MJ, Ho MN, Gottlieb L, Sternberg SS, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med. 1993;328(13):901-6. doi: 10.1056/NEJM199304013281301.
Lasisi F, Rex DK. Improving protection against proximal colon cancer by colonoscopy. Expert Rev Gastroenterol Hepatol. 2011;5(6):745-54. doi: 10.1586/egh.11.78.
Horiuchi A, Nakayama Y, Kajiyama M, Kato N, Ichise Y, Tanaka N. Benefits and limitations of cap-fitted colonoscopy in screening colonoscopy. Dig Dis Sci. 2013;58(2):534-9. doi: 10.1007/s10620-012-2403-1.
Nishimoto S, Kudo T, Horiuchi I, Yabe K, Kurasawa S, Horiuchi A. Cap-assisted colonoscopy can increase the rate of sessile serrated lesion detection at the left lateral decubitus position: A retrospective case-control study. Medicine (Baltimore). 2023;102(38):e35264. doi: 10.1097/MD.0000000000035264.
Takeuchi Y, Inoue T, Hanaoka N, Chatani R, Uedo N. Surveillance colonoscopy using a transparent hood and image-enhanced endoscopy. Dig Endosc. 2010;22 Suppl 1:S47-53. doi: 10.1111/j.1443-1661.2010.00958.x.
de Wijkerslooth TR, Stoop EM, Bossuyt PM, Mathus-Vliegen EM, Dees J, Tytgat KM, et al. Adenoma detection with cap-assisted colonoscopy versus regular colonoscopy: a randomised controlled trial. Gut. 2012;61(10):1426-34. doi: 10.1136/gutjnl-2011-301327.
Rastogi A, Bansal A, Rao DS, Gupta N, Wani SB, Shipe T, et al. Higher adenoma detection rates with cap-assisted colonoscopy: a randomised controlled trial. Gut. 2012;61(3):402-8. doi: 10.1136/gutjnl-2011-300187.
Morgan J, Thomas K, Lee-Robichaud H, Nelson RL. Transparent Cap Colonoscopy versus Standard Colonoscopy for Investigation of Gastrointestinal Tract Conditions. Cochrane Database Syst Rev. 2011;(2):CD008211. doi: 10.1002/14651858.CD008211.pub2.
Hopewell S, Clarke M, Moher D, Wager E, Middleton P, Altman DG, et al. CONSORT for reporting randomised trials in journal and conference abstracts. Lancet. 2008;371(9609):281-3. doi: 10.1016/S0140-6736(07)61835-2.
Park SY, Kim HS, Yoon KW, Cho SB, Lee WS, Park CH, et al. Usefulness of cap-assisted colonoscopy during colonoscopic EMR: a randomized, controlled trial. Gastrointest Endosc. 2011;74(4):869-75. doi: 10.1016/j.gie.2011.06.005.
Tada M, Inoue H, Yabata E, Okabe S, Endo M. Feasibility of the transparent cap-fitted colonoscope for screening and mucosal resection. Dis Colon Rectum. 1997;40(5):618-21. doi: 10.1007/BF02055390.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893-917. doi: 10.1002/ijc.25516.
Kaminski MF, Thomas-Gibson S, Bugajski M, Bretthauer M, Rees CJ, Dekker E, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy. 2017;49(4):378-397. doi: 10.1055/s-0043-103411.
Zuniga Cisneros J, Tunon C, Adames E, Garcia C, Rivera R, Gonzalez E, et al. Is There a Difference in Adenoma Detection Rates According to Indication? An Experience in a Panamanian Colorectal Cancer Screening Program. Gastroenterology Res. 2023;16(2):96-104. doi: 10.14740/gr1599.
Cubiella J, Castells A, Andreu M, Bujanda L, Carballo F, Jover R, et al. COLONPREV study investigators. Correlation between adenoma detection rate in colonoscopy- and fecal immunochemical testing-based colorectal cancer screening programs. United European Gastroenterol J. 2017;5(2):255-260. doi: 10.1177/2050640616660662.
Roldán LF, León SM, Roldán LM, Márquez S, Nuñez EE, Pérez HM, et al. ¿Podemos utilizar la indicación de colonoscopia como predictor de la tasa de detección de adenomas? Rev Colomb Gastroenterol. 2022; 37(1):41-7.
Rastogi A, Bansal A, Rao DS, Gupta N, Wani SB, Shipe T, et al. Higher adenoma detection rates with cap-assisted colonoscopy: a randomised controlled trial. Gut. 2012;61(3):402-8. doi: 10.1136/gutjnl-2011-300187.
Wada Y, Fukuda M, Ohtsuka K, Watanabe M, Fukuma Y, Wada Y, et al. Efficacy of Endocuff-assisted colonoscopy in the detection of colorectal polyps. Endosc Int Open. 2018;6(4):E425-E431. doi: 10.1055/s-0044-101142
Facciorusso A, Buccino VR, Sacco R. Endocuff-assisted versus Cap-assisted Colonoscopy in Increasing Adenoma Detection Rate. A Meta-analysis. J Gastrointestin Liver Dis. 2020;29(3):415-420. doi: 10.15403/jgld-1239.
Imaeda H, Yamaoka M, Ohgo H, Soma H, Ashitani K, Miyaguchi K, et al. Randomized control trial of adenoma detection rate in Endocuff-assisted colonoscopy versus transparent hood-assisted colonoscopy. J Gastroenterol Hepatol. 2019;34(9):1492-1496. doi: 10.1111/jgh.14771.
Sola-Vera J, Catalá L, Uceda F, Picó MD, Pérez Rabasco E, Sáez J, et al. Cuff-assisted versus cap-assisted colonoscopy for adenoma detection: results of a randomized study. Endoscopy. 2019;51(8):742-749. doi: 10.1055/a-0901-7306.
Desai M, Rex DK, Bohm ME, Davitkov P, DeWitt JM, Fischer M, et al. High-Definition Colonoscopy Compared With Cuff- and Cap-Assisted Colonoscopy: Results From a Multicenter, Prospective, Randomized Controlled Trial. Clin Gastroenterol Hepatol. 2022;20(9):2023-2031.e6. doi: 10.1016/j.cgh.2021.12.037.
Rameshshanker R, Tsiamoulos Z, Wilson A, Rajendran A, Bassett P, Tekkis P, Saunders BP. Endoscopic cuff-assisted colonoscopy versus cap-assisted colonoscopy in adenoma detection: randomized tandem study-DEtection in Tandem Endocuff Cap Trial (DETECT). Gastrointest Endosc. 2020;91(4):894-904.e1. doi: 10.1016/j.gie.2019.11.046.
Floer M, Tschaikowski L, Schepke M, Kempinski R, Neubauer K, Poniewierka E, et al. Standard versus Endocuff versus capassisted colonoscopy for adenoma detection: A randomised controlled clinical trial. United European Gastroenterol J. 2021;9(4):443-450. doi: 10.1177/2050640620982952
Parra Pérez VF. Intervenciones endoscópicas para mejorar la tasa de detección de lesiones serradas durante la colonoscopia. Rev Gastroenterol Peru. 2023;43(1):43-52. doi: 10.47892/rgp.2023.431.1466.
Pohl H, Bensen SP, Toor A, Gordon SR, Levy LC, Berk B, et al. Cap-assisted colonoscopy and detection of Adenomatous Polyps (CAP) study: a randomized trial. Endoscopy. 2015;47(10):891-7. doi: 10.1055/s-0034-1392261.
Daza Castro EM, Torres López AR, Aponte D, Rocha Rodríguez JN, Sabbagh LC. Doble revisión de colon derecho vs revisión simple durante la colonoscopia para la detección de pólipos y adenomas de colon: revisión sistemática de la literatura. Rev Gastroenterol Peru. 2023;43(4):309-18. doi: 10.47892/rgp.2023.434.1507.
Ruíz Morales OF, Otero Regino W, Gómez Zuleta MA, Castro Soteldo DJ. La Obesidad Abdominal Aumenta El Riesgo De pólipos Colorrectales. Rev Colomb Gastroenterol. 2014;29:376-382.
Boroff ES, Disbrow M, Crowell MD, Ramirez FC. Adenoma and Polyp Detection Rates in Colonoscopy according to Indication. Gastroenterol Res Pract. 2017;2017:7207595. doi: 10.1155/2017/7207595
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