Effectiveness and adverse events of endoscopic clipping versus band ligation for colonic diverticular hemorrhage: A large-scale multicenter cohort study

Katsumasa Kobayashi, Naoyoshi Nagata, Yohei Furumoto, Atsushi Yamauchi, Atsuo Yamada, Jun Omori, Takashi Ikeya, Taiki Aoyama, Naoyuki Tominaga, Yoshinori Sato, Takaaki Kishino, Naoki Ishii, Tsunaki Sawada, Masaki Murata, Akinari Takao, Kazuhiro Mizukami, Ken Kinjo, Shunji Fujimori, Takahiro Uotani, Minoru FujitaHiroki Sato, Sho Suzuki, Toshiaki Narasaka, Junnosuke Hayasaka, Mitsuru Kaise, Tomohiro Funabiki, Yuzuru Kinjo, Akira Mizuki, Shu Kiyotoki, Tatsuya Mikami, Ryosuke Gushima, Hiroyuki Fujii, Yuta Fuyuno, Naohiko Gunji, Yosuke Toya, Kazuyuki Narimatsu, Noriaki Manabe, Koji Nagaike, Tetsu Kinjo, Yorinobu Sumida, Sadahiro Funakoshi, Kana Kawagishi, Tamotsu Matsuhashi, Yuga Komaki, Kuniko Miki, Kazuhiro Watanabe, Naoki Kitano, Shu Kato, Shun Sakai, Eri Oshina, Tomohiro Mochida, Yukito Okura, Mana Matsuoka, Takahito Nozaka, Ayako Sato, Masato Yauchi, Taichi Matsumoto, Toru Asano

研究成果: ジャーナルへの寄稿学術誌査読

4 被引用数 (Scopus)

抄録

Background Prior studies have shown the effectiveness of both endoscopic band ligation (EBL) and clipping for colonic diverticular hemorrhage (CDH) but have been small and conducted at single centers. Therefore, we investigated which was the more effective and safe treatment in a multicenter long-term cohort study. Methods We reviewed data for 1679 patients with CDH who were treated with EBL (n=638) or clipping (n=1041) between January 2010 and December 2019at 49 hospitals across Japan (CODE BLUE-J study). Logistic regression analysis was used to compare outcomes between the two treatments. Results In multivariate analysis, EBL was independently associated with reduced risk of early rebleeding (adjusted odds ratio [OR] 0.46; P <0.001) and late rebleeding (adjusted OR 0.62; P <0.001) compared with clipping. These significantly lower rebleeding rates with EBL were evident regardless of active bleeding or early colonoscopy. No significant differences were found between the treatments in the rates of initial hemostasis or mortality. Compared with clipping, EBL independently reduced the risk of needing interventional radiology (adjusted OR 0.37; P =0.006) and prolonged length of hospital stay (adjusted OR 0.35; P <0.001), but not need for surgery. Diverticulitis developed in one patient (0.16%) following EBL and two patients (0.19%) following clipping. Perforation occurred in two patients (0.31%) following EBL and none following clipping. Conclusions Analysis of our large endoscopy dataset suggests that EBL is an effective and safe endoscopic therapy for CDH, offering the advantages of lower early and late rebleeding rates, reduced need for interventional radiology, and shorter length of hospital stay.

本文言語英語
ジャーナルEndoscopy
DOI
出版ステータス印刷中 - 2022

!!!All Science Journal Classification (ASJC) codes

  • 消化器病学

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