Department of Surgical and Medical Sciences, Section of Gastroenterology, University of Foggia, Foggia, Italy.
Department of Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, Utah, USA.
J Gastroenterol Hepatol. 2021 Feb;36(2):337-343. doi: 10.1111/jgh.15321. Epub 2020 Dec 1.
Evidence of a superior efficacy of EndoRings over standard colonoscopy in improving colon adenoma detection rate is lacking. We aimed to compare EndoRings and standard colonoscopy through a pairwise meta-analysis of randomized trials.
We searched the PubMed/Medline and Embase database through July 2020 and identified five randomized controlled trials (recruiting 2751 patients). The primary outcome was adenoma detection rate; secondary outcomes included advanced and sessile serrated adenoma detection rate, mean adenoma per colonoscopy, cecal intubation rate, and time. We performed pairwise meta-analysis through a random-effects model and expressed data as risk ratio and 95% confidence interval.
Overall, pooled adenoma detection rate was 53.9% (49-58.8%) with EndoRings and 49.1% (42-56.1%) with standard colonoscopy (risk ratio 1.05, 0.95-1.17). Advanced adenoma detection (risk ratio 0.91, 0.74-1.12), sessile serrated detection rate (risk ratio 1.10, 0.81-1.50), and polyp detection rate (risk ratio 1.06, 0.98-1.15) were similar between the two groups. Likewise, mean adenoma per colonoscopy (mean difference 0.17, -0.09 to 0.43), cecal intubation rate (risk ratio 1.00, 0.99-1.01), and cecal intubation time (mean difference 0.20 min, -0.34 to 0.74) did not differ between the two add-on devices. No serious adverse event was observed.
EndoRings did not seem to significantly improve the diagnostic performance of colonoscopy. Further trials are needed to confirm these results.
目前缺乏内镜黏膜下剥离环（EndoRings）优于标准结肠镜检查提高结肠腺瘤检测率的证据。我们旨在通过随机试验的成对荟萃分析来比较 EndoRings 和标准结肠镜检查。
我们通过 2020 年 7 月之前的 PubMed/Medline 和 Embase 数据库进行搜索，确定了五项随机对照试验（招募了 2751 名患者）。主要结局是腺瘤检测率；次要结局包括高级和无蒂锯齿状腺瘤检测率、每例结肠镜检查的平均腺瘤数、盲肠插管率和时间。我们通过随机效应模型进行成对荟萃分析，并以风险比和 95%置信区间表示数据。
总体而言，EndoRings 组的腺瘤总检测率为 53.9%（49-58.8%），标准结肠镜组为 49.1%（42-56.1%）（风险比 1.05，0.95-1.17）。高级腺瘤检测（风险比 0.91，0.74-1.12）、无蒂锯齿状腺瘤检测率（风险比 1.10，0.81-1.50）和息肉检测率（风险比 1.06，0.98-1.15）在两组之间相似。同样，每例结肠镜检查的平均腺瘤数（平均差异 0.17，-0.09 至 0.43）、盲肠插管率（风险比 1.00，0.99-1.01）和盲肠插管时间（平均差异 0.20 分钟，-0.34 至 0.74）在两种附加装置之间也没有差异。没有观察到严重不良事件。
EndoRings 似乎并没有显著提高结肠镜检查的诊断性能。需要进一步的试验来证实这些结果。
