Background: Cap-assisted colonoscopy uses a transparent plastic hood attached to the tip of the colonoscope to flatten the semilunar folds and improve mucosal exposure. Several studies have examined the effect of cap-assisted colonoscopy on polyp detection, but the data are inconsistent.
Objective: This study aimed to evaluate whether cap-assisted colonoscopy improves the yield of colorectal neoplasia detected compared with standard colonoscopy.
Data Sources: A systematic search of the PubMed, MEDLINE, Embase, and Cochrane databases identified 12 studies that met the inclusion criteria for data extraction.
Study Selection: Publications that compared cap-assisted colonoscopy vs standard colonoscopy in adults in a prospective randomized controlled study were selected for review.
Main Outcome Measures: The primary outcomes used for meta-analysis were cecal intubation rate, cecal intubation time, and polyp detection rate. The analysis was performed using a fixed-effect model. Outcomes were calculated as odds ratios or standardized mean differences with 95% confidence intervals. The average polyp miss rate determined by tandem colonoscopy was also calculated.
Results: The outcomes of 6185 patients were studied. Cap-assisted colonoscopy detected significantly more patients with polyps (OR 1.13; p = 0.030) and had a lower average polyp miss rate (12.2% vs 28.6%) than standard colonoscopy. Cap-assisted colonoscopy had a significantly higher cecal intubation rate than standard colonoscopy (OR 1.36; p = 0.020), whereas the time to cecal intubation (standard mean difference, 0.04 min; p = 0.280) was similar for the 2 colonoscope types.
Conclusions: Cap-assisted colonoscopy is associated with improved detection of colorectal neoplasia and higher cecal intubation rates than standard adult colonoscopy.
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[Conventional colonoscopy vs. cap-assisted colonoscopy: there are differences in colonoscopy performance?].
Rev Gastroenterol Peru
November 2024
Servicio de Gastroenterología, Hospital San Miguel Arcángel, Panamá, República de Panamá; Sistema Nacional de Investigación (SIN), Panamá, República de Panamá.
Introduction: Colonoscopy is the standard method for colorectal cancer diagnosis. Despite the use of multiple devices, polyp and adenoma detection results have been inconsistent.
Objectives: The main aim of this research is to determine if there have been differences between conventional colonoscopy (CC) and cap-assisted colonoscopy (CAC) in the diagnosis performance to detect adenomas.
Prospective randomized controlled trial of water exchange plus cap versus water exchange colonoscopy in unsedated veterans.
Gastrointest Endosc
July 2024
Veterans Affairs Greater Los Angeles Healthcare System, University of California at Los Angeles, Los Angeles, California, USA.
Background And Aims: Water exchange (WE) and cap-assisted colonoscopy separately have been shown to reduce pain during insertion in unsedated patients. We hypothesized that compared with WE, WE cap-assisted colonoscopy (WECAC) could significantly lower real-time maximum insertion pain (RTMIP).
Methods: Veterans without escort were recruited, randomized, blinded, and examined at 3 U.
Distal cap-assisted EMR allows the safe and effective resection of adherent dysplastic lesions in the setting of inflammatory bowel disease: a multicenter retrospective study (with video).
Gastrointest Endosc
December 2024
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Article Synopsis
- * A study of 16 IBD patients showed that distal cap-assisted EMR (EMR-DC) was successful in removing dysplastic lesions despite fibrosis, with 75% achieving complete resection without serious adverse events.
- * EMR-DC is a promising, effective, and cost-efficient method for treating dysplastic lesions in patients with chronic inflammatory bowel disease.
The role of cap-assisted endoscopy and its future implications.
Clin Endosc
May 2024
Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Cap-assisted endoscopy refers to a procedure in which a short tube made of a polymer (mostly transparent) is attached to the distal tip of the endoscope to enhance its diagnostic and therapeutic capabilities. It is reported to be particularly useful in: (1) minimizing blind spots during screening colonoscopy, (2) providing a constant distance from a lesion for clear visualization during magnifying endoscopy, (3) accurately assessing the size of various gastrointestinal lesions, (4) preventing mucosal injury during foreign body removal, (5) securing adequate workspace in the submucosal space during endoscopic submucosal dissection or third space endoscopy, (6) providing an optimal approach angle to a target, and (7) suctioning mucosal and submucosal tissue with negative pressure for resection or approximation. Here, we review various applications of attachable caps in diagnostic and therapeutic endoscopy and their future implications.
View Article and Find Full Text PDFCap-assisted colonoscopy can increase the rate of sessile serrated lesion detection at the left lateral decubitus position: A retrospective case-control study.
Medicine (Baltimore)
September 2023
Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
We investigated the effectiveness of cap-assisted colonoscopy conducted with the patient in the left lateral decubitus position at both the colonoscope's insertion and withdrawal timepoints compared to the effectiveness of colonoscopy without a cap conducted in the supine position at withdrawal. This was a case-control study, based on historical comparisons of patients over 2 time periods. The first group of patients underwent colonoscopies with a transparent cap and the patient was in the left lateral decubitus position at both the insertion and withdrawal timepoints from April to June 2019.
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