Advocate Aurora Health Care Milwaukee, WI, United States
Award: Presidential Poster Award
Michael Kalinowski, DO, MBA, MS1, Shana Kothari, MD, MBA, MS2, Rogelio Silva, MD3 1Advocate Aurora Health Care, Milwaukee, WI; 2Franciscan Health, Chicago, IL; 3Advocate Christ Medical Center, Oak Lawn, IL
Introduction: Colonoscopy is the gold standard in detection of colon polyps and missed adenomas account for 50% of interval colorectal cancers. Adjunctive modalities and devices are available, including external endoscopic caps used to flatten colonic folds and improve fields of view. The evidence of cap-assisted colonoscopy among the average risk population has been conflicting, specifically among patients undergoing surveillance colonoscopy. Given the lack of consensus regarding the overall benefit of cap-assisted colonoscopy, our study aimed to compare the adenoma detection rate with AmplifEYE™-assisted colonoscopy versus standard colonoscopy in high-risk patients that require surveillance colonoscopy.
Methods: This was a single-center, prospective, randomized controlled study testing adenoma detection of the AmplifEYE™ Endoscopy Device among patients undergoing surveillance colonoscopy. Informed written consent was obtained. Patients were randomized to the AmplifEYE™ or the standard colonoscopy control group. Demographic data, colonoscopy procedure and pathology reports, and colonoscopy preparation data were collected and analyzed from October 2019 to January 2021. Univariate analysis was performed.
Results: We have a total of 58 patients; 28 and 30 patients were randomized to the control and the AmplifEYE™ groups. The control group and AmplifEYE™ group had a median age of 63 and 70 years of age, respectively (p=0.0373). No significant sex or race differences were detected. No colonoscopy timing differences were found relating to instime to cecum, withdrawal time, or total procedure time among either group. The polyp detection rate was 57% for the control group and 61% for the AmplifEYE™ group (59%; p=0.7545). The control group had a higher detection of diminutive polyps (31% vs 10%) and the AmplifEYE-assisted group had a higher detection of small polyps (31% vs 42%). No correlation was observed between polyp location or pathology among the two groups (Table 1).
Discussion: The AmplifEYE™-assisted colonoscopy did not demonstrate a significant advantage to a standard colonoscopy in regards to polyp detection. The AmplifEYE™ device group detected fewer diminutive polyps which raises concerns about potential polyp detection effectiveness. The sample size was a limiting factor. Larger long-term studies incorporating additional endoscopists is warranted. Additionally, given that polyp detection did not improve with the AmplifEYE™ device, additional cost should be considered.
Figure: AmplifEYE™-Assisted Colonoscopy vs. Standard Colonoscopy Analysis
Disclosures: Michael Kalinowski indicated no relevant financial relationships. Shana Kothari indicated no relevant financial relationships. Rogelio Silva indicated no relevant financial relationships.
Michael Kalinowski, DO, MBA, MS1, Shana Kothari, MD, MBA, MS2, Rogelio Silva, MD3. P2507 - AmplifEYE™-Assisted Colonoscopy in Surveillance Colonoscopy: Adenoma Detection Rate, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.