New Developments in Mechanical Enhancement of Colonoscopy: Cuffs, Caps and Rings.
BACKGROUND
Colorectal cancer (CRC) is a common cause of cancer-related deaths. Early detection of precursor lesions in the adenoma-carcinoma sequence via colonoscopy can decrease mortality from CRC.


CONCLUSIONS
In this review article, we have summarized retrospective studies, prospective single center, multicenter studies and randomized controlled trials describing the efficacy of endocuff colonoscopy (EC), cap-assisted colonoscopy (CAC) and endorings colonoscopy (ERC). Indications, techniques, outcomes, limitations and complications reported are discussed.


CONCLUSIONS
Use of colonoscope with cap, cuff or rings attached to its distal tip has been shown to increase the polyp detection rate and adenoma detection rate, predominantly for the small polyps (<1 cm) and proximal colon location. Evidence is uniform for EC and ERC but not for CAC. Benefits of shorter cecum intubation time, improved cecum intubation rates and decreased pain scores during colonoscopy done with assistance of cuff or cap has potential to decrease the number of incomplete colonoscopy and increase overall patient satisfaction, thus improving follow-up. In the absence of any additional adverse events, EC, CAC and ERC have potential to enhance the benefits of colonoscopy.
Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia, Pa., USA.
Deepanshu
D
Jain
Naemat
N
Sandhu
Shashideep
S
Singhal
D000236:Adenoma / Q000175:diagnosis*; D002277:Carcinoma / Q000175:diagnosis*; D000068456:Clinical Studies as Topic; D003111:Colonic Polyps / Q000175:diagnosis*; D020685:Colonoscopes / Q000009:adverse effects / Q000639:trends; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods / Q000639:trends; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D006801:Humans; D016896:Treatment Outcome