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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
200
examination of the colon with a conventional colonoscope
examination of the colon with Endocuff-assisted colonoscopy
Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Institute, Attikon University General Hospital
Haidari, Attica, Greece
number and rate of missed adenomas
in the entire colon
Time frame: one week
number of adenomas and adenoma detection rate in the entire colon
with both Endocuff-assisted and standard colonoscopy
Time frame: one week
number of adenomas and adenoma detection rate in the right colon
with both Endocuff-assisted and standard colonoscopy
Time frame: one week
number of polyps and polyp detection rate in the entire colon
with both Endocuff-assisted and standard colonoscopy
Time frame: one week
number of polyps and polyp detection rate in the right colon
with both Endocuff-assisted and standard colonoscopy
Time frame: one week
colonoscopy completion (colonoscopy completion rate, reason for incomplete colonoscopy)
colonoscopy completion rate, reason for incomplete colonoscopy
Time frame: one week
intubation and withdrawal time
for both Endocuff-assisted and standard colonoscopy (time spent for therapeutic procedures is excluded)
Time frame: one week
adverse events
adverse event rate
Time frame: one week
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endoscopist's satisfaction (quantified using a scale from 0 (not satisfied) to 10 (completely satisfied)
endoscopist's satisfaction quantified using a scale from 0 (not satisfied) to 10 (completely satisfied) for Endocuff-assisted colonoscopy
Time frame: one week
mean number of adenomas per procedure
with both Endocuff-assisted and standard colonoscopy
Time frame: one week