Colorectal Neoplasms
Conditions
Brief summary
The goal of distal attachment devices is to enhance an endoscopist's adenoma detection rate (ADR). A device called EndoCuff Vision (ECV) has been introduced that employs a single row of flexible arms to evert colonic folds, thus optimizing mucosal visualization and enhancing ADR. ECV has been shown to be efficacious in improving ADR within the context of randomized trials. However, no 'real-world' studies have been published assessing the effectiveness of ECV in non-trial settings. The primary objective of this study is to assess the effect of ECV use on ADR in a routine screening-related population.
Interventions
Detachable disposable (single-use) device that fits over the distal colonoscope end.
Sponsors
Study design
Eligibility
Inclusion criteria
adult patients undergoing colonoscopy.
Exclusion criteria
* single balloon- or double balloon-assisted colonoscopy; * planned advanced polypectomy or endoscopic mucosal resection (EMR); * planned endoscopic post-polypectomy or post-EMR surveillance; * known active diverticulitis; * known colonic stricture.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adenoma detection rate (ADR) | Intra-procedural | Proportion of an endoscopist's screening-related colonoscopies during which one or more adenoma was biopsied or removed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| SSADR (sessile serrated adenoma detection rate) | Intra-procedural | Proportion of an endoscopist's screening-related colonoscopies during which one or more sessile serrated adenoma was biopsied or removed |
| CIR (cecal intubation rate) | Intra-procedural | Proportion of an endoscopist's screening-related procedures in which the cecal pole is intubated, as landmarked by direct visualization of the appendiceal orifice, ileocecal valve, or both. |
| Procedure time | Intra-procedural | Total time spent by an endoscopist from the start of the colonoscopy procedure (insertion of the colonoscope through the anus) to the end of the colonoscopy (removal of the colonoscope from the anus). This variable will be calculated only for cases in which no pathology was encountered. |
| Adenoma detection rate among patients with positive fecal immunochemical tests | Intra-procedural | Proportion of an endoscopist's colonoscopies performed for +fecal immunochemical test (FIT), or indications other than positive FIT during which one or more adenoma was biopsied or removed. In order to be included in the non-FIT ADR category, a patient must not have undergone a colonoscopy at CCSC within the last four years of the index procedure. |
| Number of patients with immediate adverse events | Day 1 | Adverse events occurring at the time of colonoscopy or before discharge, including bleeding or perforation. |
| Number of patients with delayed adverse events | Within 30 days of index procedure | Adverse events within 30 days of the index procedure, including delayed bleeding, delayed perforation, or acute healthcare utilization (emergency department visit or hospital admission) for any other reasons deemed related to index colonoscopy. |
| Nurse-assessed patient comfort scores (NAPCOMs) | Intra-procedural | Validated score for determining patients' procedural comfort. Scored from 0 to 9, with higher scores indicating higher discomfort intensity, frequency, and/or duration. |
Countries
Canada