| Original Article |
Question: What is the best strategy among combinations of stigmata of recent hemorrhage (SRH) and endoscopic treatment strategies?
Design/Method: A long-term multicenter retrospective study under the name CODE BLUE J-Study was done from 2010 until 2019. 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, propensity score–matching analysis to balance baseline characteristics between the groups being compared was used
Setting: Japan
Patient/Study community: 5823 patients with colonic diverticular bleeding (CDB) who underwent colonoscopy at 49 hospitals
Results: In comparison to not treating definitive CDB or presumptive CDB, endoscopic treatment of definitive CDB is the most successful in preventing short- and long-term recurrence. When treating patients with suspected CDB, endoscopists should try to identify and treat SRH
Commentary:
| Endoscopists should set up the appropriate endoscopic tools when diverticular bleeding is suspected based on the clinical presentation in order to recognize and treat SRH and hence avoid recurrence. SRH should be identified and treated in patients with suspected CDB as it can help prevent recurrent bleeding |
Citation: Maya Gobinet-Suguro, Naoyoshi Nagata, Katsumasa Kobayashi, et all. Treatment strategies for reducing early and late recurrence of colonic diverticular bleeding based on stigmata of recent hemorrhage: a large multicenter study. Gastrointestinal endoscopy. 2022; 95(6): 1210-1222
DOI: 10.1016/j.gie.2021.12.023
https://www.giejournal.org/article/S0016-5107(21)01937-4/pdf
Topics: Colonic Diverticular Bleeding, Stigmata of Recent Hemorrhage, Endoscopy
