Long-Term Clinical Course after Conservative and Endoscopic Treatment of Colonic Diverticular Bleeding

Akira Mizuki, Masayuki Tatemichi, Atsushi Nakazawa, Nobuhiro Tsukada, Hiroshi Nagata, Takanori Kanai

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background/Aim: What naturally happens to patients after they undergo conservative and endoscopic treatment of colonic diverticular bleeding (CDB) is largely unknown. We retrospectively track the long-term outcome of the recurrence of CDB between patients with endoscopic and conservative treatment. Methods: The group was divided into 2 groups: patients treated with injection and/or clipping (endoscopic group) and patients in whom such treatment could not be performed (conservative group). CDB recurrence was assessed via a questionnaire, and recurrence rates were investigated between groups using the Kaplan-Meier's method. The Cox proportional hazards model was performed to identify potential risk factors for recurrence. Results: Eighty-eight patients answered the questionnaires. The median (interquartile range) follow-up period was 42.7 (61.8) months. Twenty-four (38.7%) of 62 conservatively treated patients and 16 (61.5%) of 26 endoscopically treated patients experienced recurrence of CDB during the follow-up period. Kaplan-Meier's analysis showed that the rate of recurrence was significantly higher (p < 0.05) in cases with endoscopic treatment than in those with conservative treatment (mean time to recurrence = 55.3 months (95% CI 30.8-79.9) vs. 99.9 months (95%CI 80.7-119.1)). The Cox proportional hazards model did not identify any significant variables. Conclusion: We should carefully follow-up patients to check for the recurrence of CDB, even when it could be successfully treated endoscopically. Can endoscopic treatment of CDB prevent CDB recurrence? Also, what happens to the patient's well-being after they undergo conservative and endoscopic treatment (cases diagnosed by Jensen's criteria) is largely unknown. We examined a population of patients undergoing conservative or endoscopic treatment to clarify the clinical course, particularly with regard to CDB recurrence.

Original languageEnglish
Pages (from-to)186-191
Number of pages6
JournalDigestion
Volume94
Issue number4
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Hemorrhage
Recurrence
Proportional Hazards Models
Conservative Treatment
Kaplan-Meier Estimate
Therapeutics
Injections
Population

Keywords

  • Colonic diverticular bleeding
  • Endoscopic treatment
  • Recurrence

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Long-Term Clinical Course after Conservative and Endoscopic Treatment of Colonic Diverticular Bleeding. / Mizuki, Akira; Tatemichi, Masayuki; Nakazawa, Atsushi; Tsukada, Nobuhiro; Nagata, Hiroshi; Kanai, Takanori.

In: Digestion, Vol. 94, No. 4, 01.01.2017, p. 186-191.

Research output: Contribution to journalArticle

Mizuki, Akira ; Tatemichi, Masayuki ; Nakazawa, Atsushi ; Tsukada, Nobuhiro ; Nagata, Hiroshi ; Kanai, Takanori. / Long-Term Clinical Course after Conservative and Endoscopic Treatment of Colonic Diverticular Bleeding. In: Digestion. 2017 ; Vol. 94, No. 4. pp. 186-191.
@article{3fdbe4be46c840c4bbacaf569d9da2ce,
title = "Long-Term Clinical Course after Conservative and Endoscopic Treatment of Colonic Diverticular Bleeding",
abstract = "Background/Aim: What naturally happens to patients after they undergo conservative and endoscopic treatment of colonic diverticular bleeding (CDB) is largely unknown. We retrospectively track the long-term outcome of the recurrence of CDB between patients with endoscopic and conservative treatment. Methods: The group was divided into 2 groups: patients treated with injection and/or clipping (endoscopic group) and patients in whom such treatment could not be performed (conservative group). CDB recurrence was assessed via a questionnaire, and recurrence rates were investigated between groups using the Kaplan-Meier's method. The Cox proportional hazards model was performed to identify potential risk factors for recurrence. Results: Eighty-eight patients answered the questionnaires. The median (interquartile range) follow-up period was 42.7 (61.8) months. Twenty-four (38.7{\%}) of 62 conservatively treated patients and 16 (61.5{\%}) of 26 endoscopically treated patients experienced recurrence of CDB during the follow-up period. Kaplan-Meier's analysis showed that the rate of recurrence was significantly higher (p < 0.05) in cases with endoscopic treatment than in those with conservative treatment (mean time to recurrence = 55.3 months (95{\%} CI 30.8-79.9) vs. 99.9 months (95{\%}CI 80.7-119.1)). The Cox proportional hazards model did not identify any significant variables. Conclusion: We should carefully follow-up patients to check for the recurrence of CDB, even when it could be successfully treated endoscopically. Can endoscopic treatment of CDB prevent CDB recurrence? Also, what happens to the patient's well-being after they undergo conservative and endoscopic treatment (cases diagnosed by Jensen's criteria) is largely unknown. We examined a population of patients undergoing conservative or endoscopic treatment to clarify the clinical course, particularly with regard to CDB recurrence.",
keywords = "Colonic diverticular bleeding, Endoscopic treatment, Recurrence",
author = "Akira Mizuki and Masayuki Tatemichi and Atsushi Nakazawa and Nobuhiro Tsukada and Hiroshi Nagata and Takanori Kanai",
year = "2017",
month = "1",
day = "1",
doi = "10.1159/000452301",
language = "English",
volume = "94",
pages = "186--191",
journal = "Digestion",
issn = "0012-2823",
publisher = "S. Karger AG",
number = "4",

}

TY - JOUR

T1 - Long-Term Clinical Course after Conservative and Endoscopic Treatment of Colonic Diverticular Bleeding

AU - Mizuki, Akira

AU - Tatemichi, Masayuki

AU - Nakazawa, Atsushi

AU - Tsukada, Nobuhiro

AU - Nagata, Hiroshi

AU - Kanai, Takanori

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background/Aim: What naturally happens to patients after they undergo conservative and endoscopic treatment of colonic diverticular bleeding (CDB) is largely unknown. We retrospectively track the long-term outcome of the recurrence of CDB between patients with endoscopic and conservative treatment. Methods: The group was divided into 2 groups: patients treated with injection and/or clipping (endoscopic group) and patients in whom such treatment could not be performed (conservative group). CDB recurrence was assessed via a questionnaire, and recurrence rates were investigated between groups using the Kaplan-Meier's method. The Cox proportional hazards model was performed to identify potential risk factors for recurrence. Results: Eighty-eight patients answered the questionnaires. The median (interquartile range) follow-up period was 42.7 (61.8) months. Twenty-four (38.7%) of 62 conservatively treated patients and 16 (61.5%) of 26 endoscopically treated patients experienced recurrence of CDB during the follow-up period. Kaplan-Meier's analysis showed that the rate of recurrence was significantly higher (p < 0.05) in cases with endoscopic treatment than in those with conservative treatment (mean time to recurrence = 55.3 months (95% CI 30.8-79.9) vs. 99.9 months (95%CI 80.7-119.1)). The Cox proportional hazards model did not identify any significant variables. Conclusion: We should carefully follow-up patients to check for the recurrence of CDB, even when it could be successfully treated endoscopically. Can endoscopic treatment of CDB prevent CDB recurrence? Also, what happens to the patient's well-being after they undergo conservative and endoscopic treatment (cases diagnosed by Jensen's criteria) is largely unknown. We examined a population of patients undergoing conservative or endoscopic treatment to clarify the clinical course, particularly with regard to CDB recurrence.

AB - Background/Aim: What naturally happens to patients after they undergo conservative and endoscopic treatment of colonic diverticular bleeding (CDB) is largely unknown. We retrospectively track the long-term outcome of the recurrence of CDB between patients with endoscopic and conservative treatment. Methods: The group was divided into 2 groups: patients treated with injection and/or clipping (endoscopic group) and patients in whom such treatment could not be performed (conservative group). CDB recurrence was assessed via a questionnaire, and recurrence rates were investigated between groups using the Kaplan-Meier's method. The Cox proportional hazards model was performed to identify potential risk factors for recurrence. Results: Eighty-eight patients answered the questionnaires. The median (interquartile range) follow-up period was 42.7 (61.8) months. Twenty-four (38.7%) of 62 conservatively treated patients and 16 (61.5%) of 26 endoscopically treated patients experienced recurrence of CDB during the follow-up period. Kaplan-Meier's analysis showed that the rate of recurrence was significantly higher (p < 0.05) in cases with endoscopic treatment than in those with conservative treatment (mean time to recurrence = 55.3 months (95% CI 30.8-79.9) vs. 99.9 months (95%CI 80.7-119.1)). The Cox proportional hazards model did not identify any significant variables. Conclusion: We should carefully follow-up patients to check for the recurrence of CDB, even when it could be successfully treated endoscopically. Can endoscopic treatment of CDB prevent CDB recurrence? Also, what happens to the patient's well-being after they undergo conservative and endoscopic treatment (cases diagnosed by Jensen's criteria) is largely unknown. We examined a population of patients undergoing conservative or endoscopic treatment to clarify the clinical course, particularly with regard to CDB recurrence.

KW - Colonic diverticular bleeding

KW - Endoscopic treatment

KW - Recurrence

UR - http://www.scopus.com/inward/record.url?scp=85006263959&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006263959&partnerID=8YFLogxK

U2 - 10.1159/000452301

DO - 10.1159/000452301

M3 - Article

C2 - 27931020

AN - SCOPUS:85006263959

VL - 94

SP - 186

EP - 191

JO - Digestion

JF - Digestion

SN - 0012-2823

IS - 4

ER -