title: Usefulness of cap-assisted colonoscopy during colonoscopic EMR: a randomized, controlled trial.
abstract: BACKGROUND
  Clinical demand for total colonoscopy is increasing. Several articles have reported on the usefulness of a cap for faster cecal intubation and reduced patient discomfort, but results for polyp and adenoma detection have been inconsistent.
  
  
  OBJECTIVE
  To assess the efficacy of a cap attached to the tip of a colonoscope for detection and resection of polyps by experienced colonoscopists.
  
  
  METHODS
  Prospective, randomized, controlled trial.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  A total of 329 patients who underwent colonoscopic EMR were randomized to cap-assisted colonoscopy (CAC) (CAC group, n = 166) or regular colonoscopy (RC) (RC group, n = 163).
  
  
  METHODS
  Cecal intubation time, total procedure time, required time for colonoscopic EMR of each polyp, and missing polyp rate.
  
  
  RESULTS
  The cecal intubation time in the CAC group and RC group was 5.3 ± 3.3 minutes and 5.8 ± 3.7 minutes, respectively (P = .170). The total procedure time in the CAC group and RC group was 23.0 ± 15.5 minutes and 29.2 ± 13.4 minutes, respectively (P = .626). The time required for colonoscopic EMR of each polyp in the CAC group and RC group was 3.5 ± 4.5 minutes and 4.2 ± 5.1 minutes, respectively (P = .010). The number of polyps during the initial colonoscopy in the CAC group and RC group was 2.2 ± 1.7 and 2.0 ± 1.8, respectively (P = .221). The number of detected polyps during colonoscopic EMR in the CAC group and RC group was 3.4 ± 2.7 and 2.7 ± 1.9 (P = .003). The number of missed polyps in the CAC group and RC group was 1.1 ± 1.5 and 0.8 ± 0.9 (P = .024).
  
  
  CONCLUSIONS
  Single-center experience.
  
  
  CONCLUSIONS
  CAC may reduce the time required for colonoscopic EMR of each polyp and may also improve the polyp detection rate.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea.
authors.forename: Seon-Young
authors.initials: SY
authors.lastname: Park
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Kyoung-Won
authors.initials: KW
authors.lastname: Yoon
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Cho
authors.forename: Wan-Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Park
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Sung-Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Rew
mesh_terms: D003111:Colonic Polyps / Q000175:diagnosis* / Q000601:surgery*; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged