New devices improve detection of sessile-serrated adenoma

Last Updated: 2020-07-17

By Megan Brooks

NEW YORK (Reuters Health) - Devices that enhance colonic mucosal visualization during colonoscopy can improve detection of sessile-serrated adenomas (SSAs) compared with conventional colonoscopy, according to a systematic review and meta-analysis.

SSAs have emerged as "an important colon cancer precursor as we have understood that many colon cancers develop through this unique pathway, distinct from the typical adenoma-to-carcinoma sequence," authors Dr. Elijah Verheyen of Mount Sinai Health System and Dr. Violeta Popov of NYU Langone Health, both in New York City, commented in a joint email to Reuters Health.

"Prior studies have shown new technology devices, such as Endocuff, EndoRing, AmplifEYE, and G-Eye, to be effective in improving detection of typical adenomas, but given both the unique appearance and often late clinical presentation of sessile-serrated lesions, it is important to determine if this technology will help in the detection of these high-risk lesions," they explained.

To that end, the researchers performed a meta-analysis of relevant studies to compare the SSA detection rate (SSADR) with these new devices relative to conventional colonoscopy (CC).

Their analysis included 14 studies with more than 12,000 patients (mean age, 62 years, 58% male), with 5,931 patients undergoing colonoscopy with a new device and 6,724 having CC. There were 12 studies with Endocuff, two with EndoRing, one with G-Eye, and one with AmplifEYE.

In the overall analysis, there was an 81% increase in the odds of detecting SSAs with a new device (pooled SSADR, 12.3% with a mechanical device vs. 6.4% with CC; P<0.01).

When comparing the devices separately, there was an overall 113% increase in SSADR with Endocuff compared with CC (15.1% vs. 7.1%; odds ratio, 1.81; P<0.01). With EndoRing, there was a nonsignificant increase in SSADR (11.8% vs. 9.0%; OR, 1.24; P=0.31).

There was not enough data to adequately evaluate SSADR with G-Eye or AmplifEYE, although independently the studies noted increased SSADR, the researchers report in the Journal of Clinical Gastroenterology.

"Importantly, there was no difference in procedure times or serious adverse effects with the use of the new technology devices," Drs. Verheyen and Popov told Reuters Health.

Summing up, the researchers said, "New technology devices such as those described in this study have become popular among gastroenterologists to help early detection of precancerous polyps. These tools are designed to improve the endoscopists' ability to visualize the colonic mucosa, typically by flattening the colonic folds and can thereby help identify potentially worrisome lesions. This needs to be balanced against the added cost and training to use the device. With more studies showing greater benefits with low associated risk with these devices, we anticipate more widespread use given the burden of colorectal cancer."

The study had no specific funding. One author is a consultant for Olympus, which manufactures the Endocuff.

SOURCE: https://bit.ly/32p0DuY Journal of Clinical Gastroenterology, online July 8, 2020.