Introduction: EndoCuff (Olympus America) is an attachment device at the end of a colonoscope that enhances visualization of the colonic mucosa to improve polyp detection rate upon withdrawal. Some studies recommend a second pass through the right colon due to increased likelihood of missed polyps on the first pass. Documented polyp miss rates can range as high as 28% per previous studies with traditional colonoscopy. Although the EndoCuff-assisted colonoscopies result in lower polyp miss rates, the necessity of a second pass remains unknown. In our pilot study, we investigated the effects of EndoCuff on polyp detection and miss rates during the second pass in the right colon.
Methods: This survey-based study was conducted at a single community hospital. 54 participants underwent screening, diagnostic, or surveillance colonoscopies with the assistance of EndoCuff. Participant characteristics included sex (25 males, 29 females), age (39-80), and quality of prep (93% with good or excellent prep). The number of polyps detected on the first and second pass through the cecum/ascending colon were recorded and analyzed using two-proportions tests (Minitab Statistical Software).
Results: A total of 32 polyps were detected in the right colon on the first pass. Only 5 participants (9.3%) had evidence of a single missed polyp on the second pass, which occurred exclusively with the low polyp number detected on the first pass (0-1 polyp) under good/excellent prep quality.
Discussion: Our preliminary data suggest that EndoCuff is associated with effective detection of polyps during first pass. Furthermore, EndoCuff resulted in significantly lower polyp miss rates than what is routinely reported in the field. However, it remains to be determined whether a second pass is clinically necessary during screening and/or surveillance colonoscopy with the use of Endocuff. A follow-up to this study is needed with a larger number of patients to validate.
