Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/a-2005-6934
Retrospective comparison of G-EYE balloon-colonoscopy with standard colonoscopy for increased adenoma detection rate and reduced polyp removal time
TRIAL REGISTRATION: observational, retrospective, single-center study NCT04767971 at clinicaltrials.gov![](https://www.thieme-connect.de/media/10.1055-s-00025476/202309/lookinside/thumbnails/2496_10-1055-a-2005-6934-1.jpg)
Abstract
Background and study aims The newly introduced G-EYE colonoscope (G-EYE) employs a balloon, installed at the bending section of a standard colonoscope (SC), for increasing adenoma detection and stabilizing the colonoscope tip during intervention. This retrospective work explores the effect of introducing G-EYE into an SC endoscopy room, in terms of adenoma detection and polyp removal time.
Patients and methods This was a single-center, retrospective study. Historical data from patients who underwent colonoscopy prior to, and following, introduction of G-EYE into a particular endoscopy room were collected and analyzed to determine adenoma detection rate (ADR), adenoma per patient (APP), and polyp removal time (PRT), in each of the SC and G-EYE groups.
Results Records of 1362 patients who underwent SC and 1433 subsequent patients who underwent G-EYE colonoscopy in the same endoscopy unit by the same endoscopists were analyzed. Following G-EYE introduction, overall ADR increased by 37.5 % (P < 0.0001) from 39.2 % to 53.9 %, the serrated adenoma rate increased by 47.3 % from 27.9 % to 41.1 % (P < 0.0001), and the APP increased by 50.6 % from 0.79 to 1.19 (P < 0.0001). The number of advanced adenomas increased by 32.7 %, from 19.6 % to 26.0 % of all adenomas (P < 0.0001). With G-EYE, average PRT was reduced overall by 29.5 % (P < 0.0001), and particularly for endoscopic mucosal resection (EMR) by 37.5 % for polyps measuring ≥ 5 mm to ≤ 20 mm (P < 0.0001) and by 29.4 % for large polyps > 20 mm (P < 0.0001).
Conclusions Introduction of G-EYE to an SC endoscopy room yielded considerable increase in ADR and notable reduction in PRT, particularly with the EMR technique. G-EYE balloon colonoscopy might increase the effectiveness of colorectal cancer screening and surveillance colonoscopy, and can shorten the time of endoscopic intervention.
Publication History
Received: 29 July 2021
Accepted: 08 June 2022
Accepted Manuscript online:
02 January 2023
Article published online:
06 October 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Cancer Facts & Figures 2019. Atlanta: American Cancer Society 2019. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf
- 2 Levin B, Lieberman DA, McFarland B. et al. Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer and the American College of Radiology. CA Cancer J Clin 2008; 58: 130-160
- 3 Cooper GS, Chak A, Koroukian S. The polyp detection rate of colonoscopy: a national study of medicare beneficiaries. Am J Med 2005; 118: 1413
- 4 Lieberman DA, Rex DK, Winawer SJ. et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012; 143: 844-857
- 5 Zauber AG, Winawer SJ, O’Brien MJ. et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012; 366: 687-696
- 6 Zhao S, Wang S, Pan P. et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: a systematic review and meta-analysis. Gastroenterology 2019; 156: 1661-1674
- 7 Samadder NJ, Curtin K, Tuohy TMF. et al. Characteristics of missed or interval colorectal cancer and patient survival: a population-based study. Gastroenterology 2014; 146: 950-960
- 8 Gralnek IM, Siersema PD, Halpern Z. et al. Standard forward-viewing colonoscopy versus full-spectrum endoscopy: an international, multicenter, randomized, tandem colonoscopy trial. Lancet Oncol 2014; 15: 353-360
- 9 Kudo SE, Kudo T, Saito Y. et al. New-generation full-spectrum endoscopy versus standard forward-viewing colonoscopy: a multicenter, randomized, tandem colonoscopy trial (J-FUSE Study). Gastrointest Endosc 2018; 88: 854-864
- 10 Repici A, Hassan C, Senore C. et al. Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme. Gut 2017; 66: 1949-1955
- 11 Lenze F, Beyna T, Lenz P. et al. Endocuff-assisted colonoscopy: a new accessory to improve adenoma detection rate? Technical aspects and first clinical experiences. Endoscopy 2014; 46: 610-614
- 12 Bhattacharyya R, Chedgy F, Kandiah K. Endocuff-assisted vs. standard colonoscopy in the fecal occult blood test-based UK Bowel Cancer Screening Programme (E-cap study): a randomized trial. Endoscopy 2017; 49: 1043-1050
- 13 Biecker E, Floer M, Heinecke A. et al. Novel Endocuff-assisted colonoscopy significantly increases the polyp detection rate: a randomized controlled trial. J Clin Gastroenterol 2015; 49: 413-418
- 14 Triantafyllou K. Endocuff-assisted colonoscopy outperforms conventional colonoscopy to detect missed adenomas: European multicenter randomized back-to-back study. United Europ Gastroenterol J 2019; DOI: 10.3748/wjg.v25.i9.1158.
- 15 Dik VK, Gralnek IM, Segol O. et al. Multicenter, randomized, tandem evaluation of Endorings colonoscopy: Results of the CLEVER study. Endoscopy 2015; 47: 1151-1158
- 16 Gralnek IM, Suissa A, Domanov S. Safety and efficacy of a novel balloon colonoscope: a prospective cohort study. Endoscopy 2014; 46: 883-887
- 17 Halpern Z, Gross SA, Gralnek IM. et al. Comparison of adenoma detection and miss rates between a novel balloon colonoscope and standard colonoscopy: a randomized tandem study. Endoscopy 2015; 47: 238-244
- 18 Shirin H, Gross S, Kiesslich R. et al. G-EYE colonoscopy is superior to standard colonoscopy for increasing adenoma detection rate: an international randomized controlled trial. Gastrointest Endosc 2019; 89: 545-553
- 19 Corley DA, Jensen CD, Marks AR. et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014; 370: 1298-1306
- 20 Facciorusso A, Triantafyllou K, Murad MH. et al. Compared abilities of endoscopic techniques to increase colon adenoma detection rates: a network meta-analysis. Clin Gastroenterol Hepatol 2019; 17: 2439-2454
- 21 Siersema PD, Van Keulen KE, Soons E. The role of behind folds visualizing techniques and technologies in improving adenoma detection rate. Curr Treat Options Gastro 2019; 17: 394-407
- 22 Hotta K, Katsuki S, Ohata K. et al. Efficacy and safety of endoscopic interventions using the short double‐balloon endoscope in patients after incomplete colonoscopy. DEN 2015; 27: 95-98
- 23 Yamamoto H, Yamashina T, Hayashi Y. et al. Balloon-assisted endoscopy facilitates endoscopic submucosal dissection of difficult superficial proximal colon tumors. Endoscopy 2018; 50: 800-808
- 24 Ohya T, Ohata K, Tajiri H. et al. Balloon overtube-guided colorectal endoscopic submucosal dissection. World J Gastroenterol 2009; 15: 6086-6090
- 25 Sharma SK, Momose K, Hara H. et al. Facilitating endoscopic submucosal dissection: double balloon endolumenal platform significantly improves dissection time compared with conventional technique (with video). Surg Endosc 2019; 33: 315-321
- 26 Ismail MS, Bahdi F, Mercado MO. et al. ESD with double-balloon endoluminal intervention platform versus standard ESD for management of colon polyps. Endosc Int Open 2020; 8: E1273-E1279
- 27 Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy 2005; 37: 570-578
- 28 Kudo S, Tamura S, Nakajima T. et al. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc 1996; 44: 8-14
- 29 Kaminski MF, Regula J, Kraszewska E. et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 2010; 362: 1795-1803
- 30 Rex DK, Boland CR, Dominitz JA. et al. Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2017; 112: 1016-1030
- 31 Ussui V, Coe S, Wallace MB. et al. Stability of increased adenoma detection at colonoscopy: Follow-up of an endoscopic quality improvement program-EQUIP-II. Am J Gastroenterol 2015; 110: 489-496