title: Use of the Endocuff during routine colonoscopy examination improves adenoma detection: A meta-analysis.
abstract: OBJECTIVE
  To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy.
  
  
  METHODS
  Scopus, Cochrane databases, MEDLINE/PubMed, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meeting were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy (EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerSimonian and Laird models with the odds ratio (OR) to assess adenoma detection, cecal intubation rate, and complications performed.
  
  
  RESULTS
  Nine studies (n= 5624 patients) were included in the analysis. Compared to standard colonoscopy, procedures performed with EC had higher frequencies for adenoma (OR = 1.49, 95%CI: 1.23-1.80;P= 0.03), and sessile serrated adenomas detection (OR = 2.34 95%CI: 1.63-3.36;P< 0.001). There was no significant difference in cecal intubation rates between the EAC group and standard colonoscopy (OR = 1.26, 95%CI: 0.70-2.27,I2= 0%;P= 0.44). EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency for perforation.
  
  
  CONCLUSIONS
  The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy.
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: Matthew
authors.initials: M
authors.lastname: Chin
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: William
authors.initials: W
authors.lastname: Karnes
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: M Mazen
authors.initials: MM
authors.lastname: Jamal
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: John G
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Lee
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: Jason
authors.initials: J
authors.lastname: Samarasena
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
authors.affiliation: Matthew Chin, William Karnes, John G Lee, Robert Lee, Jason Samarasena, Douglas L Nguyen, Division of Gastroenterology and Hepatology, University of California Irvine, Orange, CA 92868, United States.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Nguyen
mesh_terms: D018256:Adenomatous Polyps / Q000473:pathology*; D016009:Chi-Square Distribution; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D020685:Colonoscopes; D003113:Colonoscopy / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors
keywords: Adenoma detection; Colonoscopy; Endocuff