Effect of an External Abdominal Binder on Polyp Detection during Colonoscopy

Aim: ColoWrap is an external abdominal compression device applied during colonoscopy to reduce looping and procedure time. It is unclear if a shorter procedure duration or increased abdominal pressure impacts polyp detection. We determined if use of ColoWrap affected adenoma detection rate (ADR) or detection of sessile serrated polyps (SSP) compared to sham. Materials and Methods: At a single center, participants aged 40-80 were randomized to have ColoWrap or a sham device applied to the lower abdomen. Baseline characteristics, procedural factors, location of polyps, ADR and SSP detection rate (SSPDR) were compared between the groups. Multivariable logistic regression was performed to assess whether ColoWrap was associated with detection of adenomas and SSP. Results: Of 350 participants, 175 were assigned to each arm. Overall, there were no significant differences in ADR (43% vs. 40%, p=0.52) or SSPDR (8% vs. 6%, p=0.53) between ColoWrap and sham. In sub-group analysis, there were increased odds of adenoma detection with ColoWrap in women (OR: 2.32, 95%CI: 1.21, 4.46), participants >60 years (OR: 2.95, 95%CI: 1.43, 6.07) and those with a BMI 30-40 (OR: 3.50, 95%CI: 1.00, 12.23). Use of ColoWrap also increased ADR in the left colon (splenic flexure to rectum) (29% vs. 22%; p=0.03) and increased SSPDR in the cecum/ascending colon (6% vs. 2%; p=0.02) compared to sham. Conclusion: Use of ColoWrap during colonoscopy did not negatively impact ADR or SSPDR, and while there was possible improvement in ADR in certain sub-groups, the results are inconclusive due to the small sample size.