Transparent cap-assisted colonoscopy versus standard adult colonoscopy: a systematic review and meta-analysis.
Dis Colon Rectum
; 55(2): 218-25, 2012 Feb.
Article
in En
| MEDLINE
| ID: mdl-22228167
ABSTRACT
BACKGROUND:
Cap-assisted colonoscopy uses a transparent plastic hood attached to the tip of the colonoscope to flatten the semilunar folds and improve mucosal exposure. Several studies have examined the effect of cap-assisted colonoscopy on polyp detection, but the data are inconsistent.OBJECTIVE:
This study aimed to evaluate whether cap-assisted colonoscopy improves the yield of colorectal neoplasia detected compared with standard colonoscopy. DATA SOURCES A systematic search of the PubMed, MEDLINE, Embase, and Cochrane databases identified 12 studies that met the inclusion criteria for data extraction. STUDY SELECTION Publications that compared cap-assisted colonoscopy vs standard colonoscopy in adults in a prospective randomized controlled study were selected for review. MAIN OUTCOMEMEASURES:
The primary outcomes used for meta-analysis were cecal intubation rate, cecal intubation time, and polyp detection rate. The analysis was performed using a fixed-effect model. Outcomes were calculated as odds ratios or standardized mean differences with 95% confidence intervals. The average polyp miss rate determined by tandem colonoscopy was also calculated.RESULTS:
The outcomes of 6185 patients were studied. Cap-assisted colonoscopy detected significantly more patients with polyps (OR 1.13; p = 0.030) and had a lower average polyp miss rate (12.2% vs 28.6%) than standard colonoscopy. Cap-assisted colonoscopy had a significantly higher cecal intubation rate than standard colonoscopy (OR 1.36; p = 0.020), whereas the time to cecal intubation (standard mean difference, 0.04 min; p = 0.280) was similar for the 2 colonoscope types.CONCLUSIONS:
Cap-assisted colonoscopy is associated with improved detection of colorectal neoplasia and higher cecal intubation rates than standard adult colonoscopy.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colonic Polyps
/
Colonoscopy
Type of study:
Clinical_trials
/
Prognostic_studies
/
Systematic_reviews
Limits:
Adult
/
Humans
Language:
En
Journal:
Dis Colon Rectum
Year:
2012
Type:
Article
Affiliation country:
New Zealand