TORNA ALL’ELENCO

Endocuff vision improves ADR in low detectors: Results of the itavision randomized controlled trial in Endoscopy

2021
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (4)Vedi tutti...

Antonelli G

Zorzi M

Senore C


et alii...

Abstract

Aims Endocuff Vision (EV, Arc Medical Design Ltd., Leeds, England) has shown to increase mucosal exposure, andconsequently adenoma detection rate (ADR), during colonoscopy, but its role in positive Faecal Immunochemical Test(FIT+) subjects within an organised colorectal cancer population-based screening program is uncertain. This nationwidemulticentre study aims to assess possible benefits and harms of implementing EV in a FIT-based screening program. Methods Patients undergoing colonoscopy after a FIT+, were randomised 1:1 between standard colonoscopy with EV andcontrol, stratified by gender, age, and screening history. Primary outcome was ADR, stratified by patient gender, age, andby endoscopists' ADR. Secondary outcomes were advanced ADR (AADR), adenoma per colonoscopy (APC), polyps percolonoscopy, with drawal time (WT), adverse events (AE). All outcomes were adjusted at multivariate analysis. Results Overall, 1,864 patients in 13 centers (males: 53.7 %) were randomised, 908 in the EV arm and 905 in the control.No patients' demographic or procedural characteristics differed among the two groups. ADR was significantly higher in theEV arm (47.8 % vs 40.8 %; RR 1.17, 95 %CI 1.06-1.30; p=0.002) with no differences among groups regarding size ormorphology. When stratifying for endoscopists' ADR, only low detectors (ADR< 33.3 %) showed a significant ADR increase(EV = 41.1 % vs control = 26 %; ADR difference +15.1 %; 95 %CI 7.5-22.7; p<0.001). AADR (24.8 % vs. 20.5 %, RR 1.21;95 %CI 1.02-1.43; p=0.03) and APC (0.94 vs. 0.77, p=0.001) were significantly increased in the EV group. WT and AE were similar among the two groups. Conclusions EV increased ADR in a FIT-based, organised CRC-screening program, supporting a complete exploration of colonic mucosa. Its utility was highest among endoscopists with a low ADR.

DOI : 10.1055/s-0041-1724388

Keywords

adenoma; adult; colon mucosa; colonic endoscopy cuff; colonoscopy; conference abstract; controlled study; demography; endoscopist; female; gender; human; major clinical study; male; multicenter study; outcome assessment; polyp; randomized controlled trial;