Treatment strategies for reducing early and late recurrence of colonic diverticular bleeding based on stigmata of recent hemorrhage: a large multicenter study

Treatment strategies for colonic diverticular bleeding (CDB) based on stigmata of recent hemorrhage (SRH) remain unstandardized, and no large studies have evaluated their effectiveness. We sought to identify the best strategy among combinations of SRH identification and endoscopic treatment strategi...

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Published in:Gastrointestinal endoscopy 2022-06, Vol.95 (6), p.1210-1222.e12
Main Authors: Gobinet-Suguro, Maya, Nagata, Naoyoshi, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Gunji, Naohiko, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kawagishi, Kana, Matsuhashi, Tamotsu, Komaki, Yuga, Miki, Kuniko, Watanabe, Kazuhiro, Uemura, Naomi, Itawa, Eri, Sugimoto, Mitushige, Fukuzawa, Masakatsu, Kawai, Takashi, Kaise, Mitsuru, Itoi, Takao
Format: Article
Language:English
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Summary:Treatment strategies for colonic diverticular bleeding (CDB) based on stigmata of recent hemorrhage (SRH) remain unstandardized, and no large studies have evaluated their effectiveness. We sought to identify the best strategy among combinations of SRH identification and endoscopic treatment strategies. We retrospectively analyzed 5823 CDB patients who underwent colonoscopy at 49 hospitals throughout Japan (CODE-BLUE J-Study). Three strategies were compared: find SRH (definitive CDB) and treat endoscopically, find SRH (definitive CDB) and treat conservatively, and without finding SRH (presumptive CDB) treat conservatively. In conducting pairwise comparisons of outcomes in these groups, we used propensity score–matching analysis to balance baseline characteristics between the groups being compared. Both early and late recurrent bleeding rates were significantly lower in patients with definitive CDB treated endoscopically than in those with presumptive CDB treated conservatively (
ISSN:0016-5107
1097-6779
DOI:10.1016/j.gie.2021.12.023