Cheloff Abraham Z, Gross Seth A
NYU Langone Health, 550 1st Avenue, New York, NY 10016, USA.
J Clin Med. 2025 Sep 8;14(17):6346. doi: 10.3390/jcm14176346.
High performance colonoscopy requires the monitoring of an individual's adenoma detection rate (ADR). The Endocuff (EndoCuff Vision, Olympus America Inc., Center Valley, PA, USA) is an endoscopic distal attachment device that increases surface area exposure during colonoscopy. While studies have shown that Endocuff increased ADR, real-world data is limited on its effectiveness. The Premiere Health Database was reviewed from 2018 to 2021 to identify patients 50 years of age or older who had a screening colonoscopy. A keyword search for "Endocuff" was used to determine if Endocuff was utilized, and ICD10 codes were analyzed to determine if a polyp was found. Our primary outcome was a polyp detection rate (PDR) for Endocuff-assisted colonoscopy (EAC) and standard colonoscopy (SC). Secondary outcomes included an estimated adenoma detection rate (eADR). Logistic regression modeling was performed to examine the difference in PDR between the EAC and SC groups after controlling for baseline characteristics, insurance type, and provider experience. Gastroenterologists performed 893,560 screening colonoscopies, of which 0.7% were Endocuff-assisted, while surgeons performed 234,962 screening colonoscopies and 0.5% were Endocuff-assisted. PDR was higher with EAC for both gastroenterologists (72.0% vs. 57.4%) and surgeons (55.6% vs. 43.7%), with eADR following similar trends. The odds ratio of polyp detection with vs. without Endocuff was 1.91 for gastroenterologists and 1.62 for surgeons. After adjusting for patient and provider factors, the adjusted odds ratios are 2.01 and 1.61, respectively. While Endocuff utilization remains low, this large study using real-world data demonstrates the ability to improve eADR by over 10% compared to standard colonoscopy.
高效的结肠镜检查需要监测个体的腺瘤检出率（ADR）。Endocuff（EndoCuff Vision，美国奥林巴斯美国公司，宾夕法尼亚州中心谷）是一种内镜远端附着装置，可在结肠镜检查期间增加表面积暴露。虽然研究表明Endocuff提高了ADR，但其实际效果的真实世界数据有限。对2018年至2021年的Premiere健康数据库进行了回顾，以确定年龄在50岁及以上接受筛查结肠镜检查的患者。使用关键词搜索“Endocuff”来确定是否使用了Endocuff，并分析ICD10编码以确定是否发现息肉。我们的主要结局是Endocuff辅助结肠镜检查（EAC）和标准结肠镜检查（SC）的息肉检出率（PDR）。次要结局包括估计的腺瘤检出率（eADR）。在控制基线特征、保险类型和提供者经验后，进行逻辑回归建模以检查EAC组和SC组之间PDR的差异。胃肠病学家进行了893,560例筛查结肠镜检查，其中0.7%为Endocuff辅助检查，而外科医生进行了234,962例筛查结肠镜检查，0.5%为Endocuff辅助检查。对于胃肠病学家（72.0%对57.4%）和外科医生（55.6%对43.7%），EAC的PDR均更高，eADR也呈现类似趋势。使用Endocuff与未使用Endocuff相比，胃肠病学家息肉检出的优势比为1.91，外科医生为1.62。在调整患者和提供者因素后，调整后的优势比分别为2.01和1.61。虽然Endocuff的使用率仍然较低，但这项使用真实世界数据的大型研究表明，与标准结肠镜检查相比，Endocuff能够将eADR提高超过10%。
