USE OF AN ENDOCUFF COLONOSCOPE ATTACHMENT INCREASES SESSILE SERRATED POLYP DETECTION
Recommended Citation
Chaudhary A, Harris K, Faisal MS, Toiv A, Shahzil M, Samad M, Youssef R, Farooq U, Tarar Z, Suresh S. USE OF AN ENDOCUFF COLONOSCOPE ATTACHMENT INCREASES SESSILE SERRATED POLYP DETECTION. Gastrointest Endosc 2024; 99(6):AB518-AB519.
Document Type
Conference Proceeding
Publication Date
6-1-2024
Publication Title
Gastrointest Endosc
Abstract
Background: Colonoscopy, the primary screening modality for colon cancer, faces challenges in examining less accessible areas of colon like behind the folds and inner curves of flexures. Polyps may easily be missed in these locations, especially flat polyps such as sessile serrated polyps. To overcome this, devices like the endocuff (EC) are developed. The EC is a distal cap attachment for colonoscopes that features soft projections that remain flattened during insertion and extend outwards upon withdrawal to facilitate the examination of colonic folds. Method: A retrospective chart review was performed on patients that underwent colonoscopies at one of our ambulatory surgical centers during a 4-month period in early 2023. Data was collected for a 2-month period before the EC attachment was introduced at our center and for 2-months after the EC attachment was in use. Patients who had a colonoscopy done for either colon screening or surveillance were included in the study. Patients with other indications (like diarrhea, inflammatory bowel disease assessment, etc.) were excluded from the study. Logistic regression for the rate outcome and linear regression for the continuous outcome of time were used to study EC effect after adjusting the other covariates. Results: Among 435 patients involved in the study, EC attachment was used in 189 (43%). In general, the two populations with and without EC attachment were balanced on all demographic variables except race (table 1). The EC group was predominantly white (60%) females (57%). The most common American Society of Anesthesiologists (ASA) class was 2 in 380 (87%). Bowel prep was satisfactory in 415 (95%) patients. Overall, 12 (3%) SSP were detected, almost all of them were detected with EC rather without EC [11(6%) vs 1(0.4%); p <0.01]. Altogether, 160 (37%) ileal intubations were preformed [134 (55%) without EC vs 26 (14%) with EC; p <0.01]. The mean total procedure time was 18.7 minutes, and the mean cecal intubation time was 4.37 minutes. There was no statistically significant difference between the patients with EC use and without EC use when comparing adenoma detection rate [78 (41%) vs 97 (39%)], mean cecal intubation time (4.19 ± 2.75 vs 4.50 ± 3.61 minutes), and total procedure time (18.32 ± 7.74 vs 18.99 ± 7.26 minutes). Conclusion: The use of an EC distal attachment increases detection of sessile serrated polyps (SSPs) without affecting overall colonoscopy time. There was a statically significant decrease in ileal intubation when the EC was used. Physicians should consider the indication for their exam when determining whether or not to use an EC attachment. Although there was no statistically significant difference in adenoma detection rate, the notable improvement in SSP detection highlights the potential value of the EC in enhancing the efficacy of colonoscopies.
Volume
99
Issue
6
First Page
AB518
Last Page
AB519
