PWE-376 Endocuff-visiontm: impact on colonoscopist performance during screening

Abstract

<h3>Introduction</h3> Although colonoscopy is considered the optimal procedure for bowel cancer screening, it remains an imperfect tool for cancer prevention, due to missed adenomas and early cancers. The Endocuff is a simple device attached at the end of the colonoscope that opens up the field of view by retracting folds during withdrawal. Little is known regarding the Endocuff’s impact on a colonoscopist’s performance. <h3>Method</h3> The aim of this study was to evaluate the impact of the Endocuff-vision^TM(ARC Design Ltd, UK) on the quality indicators for each operator. A prospective observational evaluation study was performed from April 2013 to September 2014, divided in three consecutive periods: pre-cuff (no device used), during-cuff (device used) and post-cuff (no device used). Four screening endoscopists (BPS, STG, NS, AH) utilised the Endocuff-vision^TMat their own discretion when device was available to them. Quality colonoscopy indicators {(Adenoma Detection Rate (ADR), Mean number of adenomas per procedure (MAP), Caecal intubation time (CIT)} were analysed (t-test two sample assuming equal variances) in equivalent number of procedures. The total number of procedures performed was 399, 133 per period (BPS/26, STG/53, NS/31, AH/23). <h3>Results</h3> The mean ADR was 55.13% in the pre-cuff period, 68.98% in the during-cuff period and 61.74% in the post-cuff period. All four operators showed significant improvement in detection when using the device, which resulted in an overall increased ADR of <b>13.8% </b>(p &lt; 0.05). During the post-cuff period, the detection performance of the three endoscopists declined while maintaining a high detection rate. The mean MAP was 1.2 in the pre-cuff period, 2.2 in the during-cuff period and 1.55 in the post-cuff period. The mean MAP increased significantly in all four operators at the during-cuff period (<b>83%</b>, p &lt; 0.05). During the post-cuff, 3 endoscopists returned almost to the baseline MAP pre-cuff level. The mean CIT was 9.66min in the pre-cuff period, 7.5min in the during-cuff period and 9.54min in the post-cuff period. A decrease in mean CIT was featured (<b>22.36%</b>, p &lt; 0.005) to all operators when using the device, returning to about the pre-cuff levels afterwards. No complications were reported from the use of the Endocuff-vision although it was electively removed in 4 cases with severe sigmoid colon diverticulosis and one case due to anal discomfort. <h3>Conclusion</h3> In this study, use of the Endocuff-vision^TMimproved overall performance by making colonoscopy a quicker (CIT) and more efficient (MAP/ADR) procedure. Further randomised evaluation of this simple novel device is warranted. <h3>Disclosure of interest</h3> None Declared.