BACKGROUND & AIMS Mucosal exposure devices improve detection of lesions during colonoscopy and have reduced examination times in uncontrolled studies. We performed a randomized trial of Endocuff Vision vs standard colonoscopy to compare differences in withdrawal time (the primary end point). We proposed that Endocuff Vision would allow complete mucosal inspection in a shorter time without impairing lesion detection. METHODS Adults older than 40 years undergoing screening or surveillance colonoscopies were randomly assigned to the Endocuff group (n=101, 43.6% women) or the standard colonoscopy group (n=99; 57.6% women). One of 2 experienced endoscopists performed the colonoscopies, aiming for a thorough evaluation of the proximal sides of all haustral folds, flexures, and valves in the shortest time possible. Inspection time was measured with a stopwatch and calculated by subtracting washing, suctioning, polypectomy and biopsy times from total withdrawal time. RESULTS There were significantly fewer women in the Endocuff arm (P = .0475) but there were no other demographic differences between groups. Mean insertion time with Endocuff was 4.0 min vs 4.4 min for standard colonoscopy (P = .14). Mean inspection time with Endocuff was 6.5 min vs 8.4 min for standard colonoscopy (P < .0001). Numbers of adenomas detected per colonoscopy (1.43 vs 1.07; P = .07), adenoma detection rate (61.4% vs 52%; P = .21), number of sessile serrated polyps per colonoscopy (0.27 vs 0.21; P = .12), and sessile serrated polyp detection rate (19.8% vs 11.1%; P = .09) were all higher with Endocuff Vision. Results did not differ significantly when we controlled for age, sex, or race. CONCLUSION In a randomized trial, we found inclusion of Endocuff in screening or surveillance colonoscopies to decrease examination time without reducing lesion detection. ClinicalTrials.gov, Number: NCT03361917.

中文翻译：

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颈内窥镜检查可减少检查时间而又不减少病变检出率：一项临床随机试验。

背景与目的粘膜暴露装置可改善结肠镜检查过程中对病变的检测，并减少非对照研究中的检查时间。我们进行了Endocuff Vision与标准结肠镜检查的随机试验，以比较停药时间（主要终点）的差异。我们建议使用Endocuff Vision可以在更短的时间内完成完整的粘膜检查，而不会损害病变的检测。方法接受筛查或监测结肠镜检查的40岁以上成年人被随机分配到Endocuff组（n = 101，女性占43.6％）或标准结肠镜检查组（n = 99，女性占57.6％）。2名经验丰富的内镜医师中的一名进行了结肠镜检查，目的是在尽可能短的时间内对所有腹侧褶皱，弯曲和瓣膜的近侧进行全面评估。用秒表测量检查时间，并通过从总退出时间中减去清洗，抽吸，息肉切除术和活检时间来计算检查时间。结果内吞臂妇女的数量明显减少（P = .0475），但两组之间在人口统计学上没有其他差异。使用Endocuff的平均插入时间为4.0分钟，而标准结肠镜检查的平均插入时间为4.4分钟（P = .14）。Endocuff的平均检查时间为6.5分钟，而标准结肠镜检查的平均检查时间为8.4分钟（P <.0001）。结肠镜检查发现的腺瘤数目（1.43 vs 1.07; P = .07），腺瘤检出率（61.4％vs 52％; P = 0.21），每次结肠镜检查无蒂锯齿状息肉数目（0.27 vs 0.21; P = 0.12） ，Endocuff Vision的无蒂锯齿状息肉检出率（分别为19.8％和11.1％； P = .09）更高。当我们控制年龄，性别，或种族。结论在一项随机试验中，我们发现Endocuff包括在筛查或监测结肠镜检查中，以减少检查时间而不减少病变检测。ClinicalTrials.gov，编号：NCT03361917。