Rex, Douglas K.Repici, AlessandroGross, Seth A.Hassan, CesarePonugoti, Prasanna L.Garcia, Jonathan R.Broadley, Heather M.Thygesen, Jack C.Sullivan, Andrew W.Tippins, William W.Main, Samuel A.Eckert, George J.Vemulapalli, Krishna C.2018-04-192018-04-192018Rex, D. K., Repici, A., Gross, S. A., Hassan, C., Ponugoti, P. L., Garcia, J. R., … Vemulapalli, K. C. (2018). High-definition colonoscopy versus Endocuff versus EndoRings versus Full-Spectrum Endoscopy for adenoma detection at colonoscopy: a multicenter randomized trial. Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2018.02.043https://hdl.handle.net/1805/15872Background Devices used to improve polyp detection during colonoscopy have seldom been compared with each other. Methods We performed a 3-center prospective randomized trial comparing high-definition (HD) forward-viewing colonoscopy alone to HD with Endocuff to HD with EndoRings to the Full Spectrum Endoscopy (FUSE) system. Patients were age ≥50 years and had routine indications and intact colons. The study colonoscopists were all proven high-level detectors. The primary endpoint was adenomas per colonoscopy (APC) Results Among 1,188 patients who completed the study, APC with Endocuff (APC Mean ± SD 1.82 ± 2.58), EndoRings (1.55 ± 2.42), and standard HD colonoscopy (1.53 ± 2.33) were all higher than FUSE (1.30 ± 1.96,) (p<0.001 for APC). Endocuff was higher than standard HD colonoscopy for APC (p=0.014) . Mean cecal insertion times with FUSE (468 ± 311 seconds) and EndoRings (403 ± 263 seconds) were both longer than with Endocuff (354 ± 216 seconds) (p=0.006 and 0.018, respectively). Conclusions For high-level detectors at colonoscopy, forward-viewing HD instruments dominate the FUSE system, indicating that for these examiners image resolution trumps angle of view. Further, Endocuff is a dominant strategy over EndoRings and no mucosal exposure device on a forward-viewing HD colonoscope.enPublisher Policyhd colonoscopyadenoma detectionfull spectrum endoscopyArticle