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Endocuff-assisted vs. Standard Colonoscopy

Not Applicable
Completed
Conditions
Colon Neoplasms
Interventions
Procedure: Endocuff-assisted colonoscopy
Procedure: standard colonoscopy
Registration Number
NCT02340065
Lead Sponsor
Attikon Hospital
Brief Summary

The aim of this study is to evaluate Endocuff- assisted colonoscopy in terms of its possible additive contribution in the detection of important lesions, namely polyps and cancers, compared to standard colonoscopy, in a series of patients undergoing back-to-back screening or surveillance colonoscopies in a randomized fashion. Moreover, we aim to assess possible changes regarding post-polypectomy surveillance programs following Endocuff utilization.

Detailed Description

Tandem colonoscopies studies results, show that novel endoscopic technologies detect about 20% more adenomas than those conventional colonoscopy does (missed adenomas). Since Endocuff-assisted colonoscopy cannot be considered as a perfect examination, we hypothesize that conventional colonoscopy will detect one third of the missed adenomas that Endocuff-assisted colonoscopy detects in a similar setting. Therefore a sample size of 120 adenomas achieves 80% power to detect an odds ratio of 3.0 using a two-sided McNemar test with a significance level of 0.05. The odds ratio is equivalent to a difference between two paired proportions of 14% which occurs when the proportion of detected missed adenomas during Endocuff-assisted colonoscopy is 21% and the proportion of missed adenomas during conventional colonoscopy is 7%. During one year period before the study initiation, our colonoscopy performance quality data show that we detect a mean number of adenomas per patient equal of 0.7 in a population similar to the one recruited in our study. Therefore, 172 patients overall will be required to detect 120 adenomas. Given the uncertainty of our estimation and in order to cope with patients exclusions, withdrawals and unexpected incomplete colonoscopies, we decided to recruit 200 patients.

A more extensive description regarding the investigators study is provided in the following fields.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  • adults undergoing elective screening or surveillance colonoscopy
  • symptomatic adults with indication for colonoscopy
Exclusion Criteria
  • age<18 and > 80 years
  • poor overall health (ASA III, IV)
  • recent abdominal surgery
  • presence of abdominal wall hernias
  • active colitis
  • previous bowel resection
  • inflammatory bowel disease
  • polyposis syndromes

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
standard colonoscopyEndocuff-assisted colonoscopytotal polyp/adenoma detection with standard colonoscopy, polyp/adenoma detection in the right colon with standard colonoscopy
Endocuff-assisted colonoscopystandard colonoscopytotal polyp/adenoma detection with Endocuff-assisted colonoscopy, polyp/adenoma detection in the right colon with Endocuff-assisted colonoscopy
Primary Outcome Measures
NameTimeMethod
number and rate of missed adenomasone week

in the entire colon

Secondary Outcome Measures
NameTimeMethod
number of adenomas and adenoma detection rate in the entire colonone week

with both Endocuff-assisted and standard colonoscopy

mean number of adenomas per procedureone week

with both Endocuff-assisted and standard colonoscopy

number of polyps and polyp detection rate in the right colonone week

with both Endocuff-assisted and standard colonoscopy

endoscopist's satisfaction (quantified using a scale from 0 (not satisfied) to 10 (completely satisfied)one week

endoscopist's satisfaction quantified using a scale from 0 (not satisfied) to 10 (completely satisfied) for Endocuff-assisted colonoscopy

number of adenomas and adenoma detection rate in the right colonone week

with both Endocuff-assisted and standard colonoscopy

number of polyps and polyp detection rate in the entire colonone week

with both Endocuff-assisted and standard colonoscopy

colonoscopy completion (colonoscopy completion rate, reason for incomplete colonoscopy)one week

colonoscopy completion rate, reason for incomplete colonoscopy

intubation and withdrawal timeone week

for both Endocuff-assisted and standard colonoscopy (time spent for therapeutic procedures is excluded)

adverse eventsone week

adverse event rate

Trial Locations

Locations (1)

Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital

🇬🇷

Haidari, Attica, Greece

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