N82: Endocuff-Assisted Colonoscopy Versus Standard Colonoscopy In The Surveillance Of Serrated Polyposis Syndrome. A Randomized, Controlled And Multicenter Study

L. Rivero-Sánchez1, 2, J. López Vicente3, L. Hernandez4, I. Puig Althaia5, C. Arnau2, L. Moreno2, M. Díaz2, C. Rodriguez de Miguel6, T. Ocaña7, L. Moreira1, 2, 8, M. Cuatrecasas 9, S. Carballal1, 2, 8, A. Sánchez1, 2, 8, J. Llach1, F. Balaguer1, 2, 8, M. Pellisé1, 2, 8

1 – Hospital Clinic de Barcelona. Department of Gastroenterology and Digestive Endoscopy Unit. 2 – Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Barcelona, Spain. 3 – Hospital Universitario de Móstoles. Digestive System Service. Móstoles, Spain. 4 – Villalba Hospital Santos Reyes. Digestive System Service. Aranda de Duero, Spain. 5 – Xarxa Assistencial Universitària de Manresa. Digestive System Service. Manresa, Spain. 6 – Hospital Clinic de Barcelona. Digestive Endoscopy Unit. Barcelona, Spain. 7 – Hospital Clinic de Barcelona. Department of Gastroenterology. Barcelona, Spain. 8 – Center for Biomedical Research in the Hepatic and Digestive Diseases Network (CIBERehd). Barcelona, Spain. 9 – Hospital Clinic. Department of Pathology. Barcelona, Spain.

 

Aim: Serrated polyposis syndrome (SPS) is a high-risk condition of colorectal cancer. Endocuff device have demonstrated to improve the adenoma detection in mixed population. We aimed to ascertain if Endocuff-Assisted Colonoscopy (EAC) improves the detection of the serrated lesions (SL) during the surveillance of SPS.

Method: Patients with SPS (criteria I and/or III) and previous resection of all SL ≥4mm were consecutively randomized 1:1 to EAC or standard colonoscopy (SC) performed by endoscopists devoted to high-risk conditions of colorectal cancer. The main outcome was the number of SL per patient.

Results: 122 patients (SC n=60; EAC n=62; 59% men;age 61±7y) were included in 4 centers. Baseline characteristics (demographics,type of SPS, CRC history, last colonoscopy data) cecal intubation(100%) and withdrawal time were similar between groups. The mean (standard deviation) of lesions per patient for SC and EAC were: SL 5.0 (4.4) versus 5.8 (5.5)(p=0.361); total polyps 6.8 (4.7) versus 7.8 (5.7) (p=0.317); SL ≥5mm 2.2 (2.6) versus 3.1 (3.4) (p=0.141); adenomas 0.5 (0.9) versus 0.9 (1.6) (p=0.121) respectively. A polypectomy-related microperforation in the SC group was successfully solved with clips during the same procedure without major consequences for the patient.

Conclusion: The EAC does not significantly improve the efficacy of surveillance colonoscopy in the SPS.

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