Introduction: Although several studies in Western countries have shown that Endocuff Vision-assisted colonoscopy (EC) can improve the colorectal adenoma detection rate (ADR), such evidence in Asia is still scarce. This study aimed to evaluate the performance of EC in detecting colorectal adenomas in Vietnamese patients. Methods: This was a randomized controlled trial conducted at a tertiary hospital in Vietnam. Subjects aged ≥18 years referred for colonoscopy for symptomatic investigation or screening were randomly assigned to the EC group or standard colonoscopy (SC) group. The primary outcome was the ADR. The secondary outcomes included the mean number of adenomas per procedure (MAP), cecal intubation time, and withdrawal time. Results: There were 476 participants (241 in the EC group, 235 in the SC group) with a median age of 52 (interquartile range [IR]: 46, 58) years. There were no significant differences between the two groups regarding age, sex, smoking status, family history of colorectal cancer, or indications for colonoscopy. Compared with the SC group, the EC group had significantly higher ADRs (35.7% vs. 22.6%, p = 0.002) and MAPs (0.68 vs. 0.39, p = 0.004). The intubation durations were comparable between the two groups. The withdrawal time in the EC group was shorter than that in the SC group (median [seconds]: 266 [IR: 224, 314] vs. 360 [IR: 310, 390], p < 0.001). Conclusions: Compared with SC, EC significantly increased both the ADR and MAP in a shorter inspection time and could be a better choice for colonoscopy screening.

1.
Sung
H
,
Ferlay
J
,
Siegel
RL
,
Laversanne
M
,
Soerjomataram
I
,
Jemal
A
, et al
.
Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
.
CA Cancer J Clin
.
2021
;
71
(
3
):
209
49
.
2.
Winawer
SJ
,
Zauber
AG
,
Ho
MN
,
O'Brien
MJ
,
Gottlieb
LS
,
Sternberg
SS
, et al
.
Prevention of colorectal cancer by colonoscopic polypectomy. The national polyp study workgroup
.
NEJM
.
1993
;
329
(
27
):
1977
81
.
3.
Zauber
AG
,
Winawer
SJ
,
O'Brien
MJ
,
Lansdorp-Vogelaar
I
,
van Ballegooijen
M
,
Hankey
BF
, et al
.
Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths
.
NEJM
.
2012
;
366
(
8
):
687
96
.
4.
Shaukat
A
,
Kahi
CJ
,
Burke
CA
,
Rabeneck
L
,
Sauer
BG
,
Rex
DK
.
ACG clinical guidelines: colorectal cancer screening 2021
.
Am J Gastroenterol
.
2021
;
116
(
3
):
458
79
.
5.
Sung
JJY
,
Chiu
H-M
,
Lieberman
D
,
Kuipers
EJ
,
Rutter
MD
,
Macrae
F
, et al
.
Third Asia-Pacific consensus recommendations on colorectal cancer screening and postpolypectomy surveillance
.
Gut
.
2022
;
71
(
11
):
2152
66
.
6.
Shukla
J
,
Samanta
J
.
Endocuff vision to improve adenoma vision: a brief overview
.
J Dig Endosc
.
2022
;
13
(
03
):
193
8
.
7.
Patel
HK
,
Chandrasekar
VT
,
Srinivasan
S
,
Patel
SK
,
Dasari
CS
,
Singh
M
, et al
.
Second-generation distal attachment cuff improves adenoma detection rate: meta-analysis of randomized controlled trials
.
Gastrointest Endosc
.
2021
;
93
(
3
):
544
3.e7
.
8.
Wang
J
,
Ye
C
,
Fei
S
.
Endocuff-assisted versus standard colonoscopy for improving adenoma detection rate: meta-analysis of randomized controlled trials
.
Tech Coloproctol
.
2023
;
27
(
2
):
91
101
.
9.
Weissman
S
,
Mehta
TI
,
Stein
DJ
,
Tripathi
K
,
Rosenwald
N
,
Kolli
S
, et al
.
Comparative efficacy of endoscopic assist devices on colonic adenoma detection: a systematic review with network meta-analysis
.
J Clin Gastroenterol
.
2022
;
56
(
10
):
889
94
.
10.
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
31
.
11.
Aniwan
S
,
Mekritthikrai
K
,
Kerr
SJ
,
Tiankanon
K
,
Vandaungden
K
,
Sritunyarat
Y
, et al
.
Computer-aided detection, mucosal exposure device, their combination, and standard colonoscopy for adenoma detection: a randomized controlled trial
.
Gastrointest Endosc
.
2023
;
97
(
3
):
507
16
.
12.
Pattarajierapan
S
,
Tipmanee
P
,
Supasiri
T
,
Wisedopas
N
,
Khomvilai
S
.
Texture and color enhancement imaging (TXI) plus endocuff vision versus TXI alone for colorectal adenoma detection: a randomized controlled trial
.
Surg Endosc
.
2023
;
37
(
11
):
8340
8
.
13.
Lui
TK-L
,
Lam
CP-M
,
To
EW-P
,
Ko
MK-L
,
Tsui
VWM
,
Liu
KS-H
, et al
.
Endocuff with or without artificial intelligence-assisted colonoscopy in detection of colorectal adenoma: a randomized colonoscopy trial
.
Am J Gastroenterol
.
2024
;
119
(
7
):
1318
25
.
14.
Botteri
E
,
Iodice
S
,
Raimondi
S
,
Maisonneuve
P
,
Lowenfels
AB
.
Cigarette smoking and adenomatous polyps: a meta-analysis
.
Gastroenterol.
.
2008
;
134
(
2
):
388
95
.
15.
Wilschut
JA
,
Habbema
JDF
,
Ramsey
SD
,
Boer
R
,
Looman
CWN
,
van Ballegooijen
M
.
Increased risk of adenomas in individuals with a family history of colorectal cancer: results of a meta-analysis
.
Cancer Causes Control
.
2010
;
21
(
12
):
2287
93
.
16.
Floer
M
,
Biecker
E
,
Fitzlaff
R
,
Röming
H
,
Ameis
D
,
Heinecke
A
, et al
.
Higher adenoma detection rates with endocuff-assisted colonoscopy: a randomized controlled multicenter trial
.
PLoS One
.
2014
;
9
(
12
):
e114267
.
17.
Yeoh
KG
,
Ho
KY
,
Chiu
HM
,
Zhu
F
,
Ching
JYL
,
Wu
DC
, et al
.
The Asia-Pacific Colorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects
.
Gut
.
2011
;
60
(
9
):
1236
41
.
18.
Calderwood
AH
,
Jacobson
BC
.
Comprehensive validation of the Boston bowel preparation scale
.
Gastrointest Endosc
.
2009
;
69
(
5
):
AB120
1
.
19.
The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002
.
Gastrointest Endosc
.
2003
;
58
(
6
):
S3
43
.
20.
Iwatate
M
,
Hirata
D
,
Sano
Y
.
NBI International Colorectal Endoscopic (NICE) classification
.
Endosc Early Gastrointest Cancers
.
2021
;
1
:
69
74
.
21.
Nagtegaal
ID
,
Odze
RD
,
Klimstra
D
,
Paradis
V
,
Rugge
M
,
Schirmacher
P
, et al
.
The 2019 WHO classification of tumours of the digestive system
.
Histopathol
.
2020
;
76
(
2
):
182
8
.
22.
Schlemper
RJ
,
Riddell
RH
,
Kato
Y
,
Borchard
F
,
Cooper
HS
,
Dawsey
SM
, et al
.
The Vienna classification of gastrointestinal epithelial neoplasia
.
Gut
.
2000
;
47
(
2
):
251
5
.
23.
Ngu
WS
,
Bevan
R
,
Tsiamoulos
ZP
,
Bassett
P
,
Hoare
Z
,
Rutter
MD
, et al
.
Improved adenoma detection with Endocuff Vision: the ADENOMA randomised controlled trial
.
Gut
.
2019
;
68
(
2
):
280
8
.
24.
Zorzi
M
,
Hassan
C
,
Battagello
J
,
Antonelli
G
,
Pantalena
M
,
Bulighin
G
, et al
.
Adenoma detection by Endocuff-assisted versus standard colonoscopy in an organized screening program: the “ItaVision” randomized controlled trial
.
Endosc
.
2022
;
54
(
2
):
138
47
.
25.
Quach
DT
,
Nguyen
OT
.
Clinical, endoscopic and pathogical characteristics of early-onset colorectal cancer in Vietnamese
.
Asian Pac J Cancer Prev
.
2012
;
13
(
5
):
1767
70
.
26.
González-Fernández
C
,
García-Rangel
D
,
Aguilar-Olivos
N
,
Barreto-Zúñiga
R
,
Romano-Munive
A
,
Grajales-Figueroa
G
, et al
.
Higher adenoma detection rate with the endocuff: a randomized trial
.
Endosc
.
2017
;
49
(
11
):
1061
8
.
27.
Wark
PA
,
Wu
K
,
van 't Veer
P
,
Fuchs
CF
,
Giovannucci
EL
.
Family history of colorectal cancer: a determinant of advanced adenoma stage or adenoma multiplicity
.
Int J Can
.
2009
;
125
(
2
):
413
20
.
28.
Williet
N
,
Tournier
Q
,
Vernet
C
,
Dumas
O
,
Rinaldi
L
,
Roblin
X
, et al
.
Effect of Endocuff-assisted colonoscopy on adenoma detection rate: meta-analysis of randomized controlled trials
.
Endosc
.
2018
;
50
(
9
):
846
60
.
29.
Mehrotra
A
,
Morris
M
,
Gourevitch
RA
,
Carrell
DS
,
Leffler
DA
,
Rose
S
, et al
.
Physician characteristics associated with higher adenoma detection rate
.
Gastrointest Endosc
.
2018
;
87
(
3
):
778
86.e5
.
30.
Kawamura
T
,
Sekiguchi
M
,
Takamaru
H
,
Mizuguchi
Y
,
Horiguchi
G
,
Toyoizumi
H
, et al
.
Endoscopist-related factors affecting adenoma detection during colonoscopy: data from the J-SCOUT study
.
Dig Endosc
.
2024
;
36
(
1
):
51
8
.
31.
Zhu
C
,
Wang
Y
,
Zhang
H
,
Yang
Q
,
Zou
Y
,
Ye
Y
, et al
.
Morphology, histopathology, and anatomical distribution of sporadic colorectal polyps in Chinese patients
.
Gastro Hep Adv
.
2023
;
2
(
7
):
964
70
.
32.
Le
NQ
,
Huynh
TM
,
Quach
DT
,
Le
QD
.
Study on the value of JNET classification in predicting histopathology of colorectal polyps (vienamese)
.
Vietnam Med J
.
2023
;
525
(
1B
):
75
81
.
33.
Meester
RGS
,
van Herk
MMAGC
,
Lansdorp-Vogelaar
I
,
Ladabaum
U
.
Prevalence and clinical features of sessile serrated polyps: a systematic review
.
Gastroenterol
.
2020
;
159
(
1
):
105
18.e25
.
34.
Verheyen
E
,
Castaneda
D
,
Gross
SA
,
Popov
V
.
Increased sessile serrated adenoma detection rate with mechanical new technology devices: a systematic review and meta-analysis
.
J Clin Gastroenterol
.
2021
;
55
(
4
):
335
42
.
35.
Zauber
AG
,
Winawer
SJ
.
Initial management and follow-up surveillance of patients with colorectal adenomas
.
Gastroenterol Clin North Am
.
1997
;
26
(
1
):
85
101
.
36.
Spadaccini
M
,
Hassan
C
,
Rondonotti
E
,
Antonelli
G
,
Andrisani
G
,
Lollo
G
, et al
.
Combination of mucosa-exposure device and computer-aided detection for adenoma detection during colonoscopy: a randomized trial
.
Gastroenterol
.
2023
;
165
(
1
):
244
51.e3
.
37.
Lee
S-H
,
Park
YK
,
Lee
DJ
,
Kim
KM
.
Colonoscopy procedural skills and training for new beginners
.
World J Gastroenterol
.
2014
;
20
(
45
):
16984
95
.
38.
Keswani
RN
,
Crockett
SD
,
Calderwood
AH
.
AGA clinical practice update on strategies to improve quality of screening and surveillance colonoscopy: expert review
.
Gastroenterol.
.
2021
;
161
(
2
):
701
11
.
39.
Kaminski
M
,
Thomas-Gibson
S
,
Bugajski
M
,
Bretthauer
M
,
Rees
C
,
Dekker
E
, et al
.
Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative
.
Endosc
.
2017
;
49
(
4
):
378
97
.
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