Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding: a multicenter retrospective cohort study

Atsushi Yamauchi; Naoki Ishii; Atsuo Yamada; Katsumasa Kobayashi; Jun Omori; Takashi Ikeya; Taiki Aoyama; Naoyuki Tominaga; Yoshinori Sato; Takaaki Kishino; Tsunaki Sawada; Masaki Murata; Akinari Takao; Kazuhiro Mizukami; Ken Kinjo; Shunji Fujimori; Takahiro Uotani; Minoru Fujita; Hiroki Sato; Sho Suzuki; Toshiaki Narasaka; Junnosuke Hayasaka; 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; Kiyonori Kobayashi; Tamotsu Matsuhashi; Yuga Komaki; Kuniko Miki; Kazuhiro Watanabe; Yuki Mori; Kazuki Osawa; Sota Nakagami; Yuya Kawai; Takaaki Yoshikawa; Mitsuru Kaise; Naoyoshi Nagata

doi:10.1016/j.gie.2023.02.014

Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding: a multicenter retrospective cohort study

Atsushi Yamauchi, Naoki Ishii, Atsuo Yamada, Katsumasa Kobayashi, Jun Omori, Takashi Ikeya, Taiki Aoyama, Naoyuki Tominaga, Yoshinori Sato, Takaaki Kishino, Tsunaki Sawada, Masaki Murata, Akinari Takao, Kazuhiro Mizukami, Ken Kinjo, Shunji Fujimori, Takahiro Uotani, Minoru Fujita, Hiroki Sato, Sho SuzukiToshiaki Narasaka, Junnosuke Hayasaka, 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, Kiyonori Kobayashi, Tamotsu Matsuhashi, Yuga Komaki, Kuniko Miki, Kazuhiro Watanabe, Yuki Mori, Kazuki Osawa, Sota Nakagami, Yuya Kawai, Takaaki Yoshikawa, Mitsuru Kaise, Naoyoshi Nagata

Emergency Medicine

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Background and Aims: Ligation therapy, including endoscopic detachable snare ligation (EDSL) and endoscopic band ligation (EBL), has emerged as an endoscopic treatment for colonic diverticular bleeding (CDB); its comparative effectiveness and risk of recurrent bleeding remain unclear, however. Our goal was to compare the outcomes of EDSL and EBL in treating CDB and identify risk factors for recurrent bleeding after ligation therapy. Methods: We reviewed data of 518 patients with CDB who underwent EDSL (n = 77) or EBL (n = 441) in a multicenter cohort study named the Colonic Diverticular Bleeding Leaders Update Evidence From Multicenter Japanese Study (CODE BLUE-J Study). Outcomes were compared by using propensity score matching. Logistic and Cox regression analyses were performed for recurrent bleeding risk, and a competing risk analysis was used to treat death without recurrent bleeding as a competing risk. Results: No significant differences were found between the 2 groups in terms of initial hemostasis, 30-day recurrent bleeding, interventional radiology or surgery requirements, 30-day mortality, blood transfusion volume, length of hospital stay, and adverse events. Sigmoid colon involvement was an independent risk factor for 30-day recurrent bleeding (odds ratio, 1.87; 95% confidence interval, 1.02-3.40; P =.042). History of acute lower GI bleeding (ALGIB) was a significant long-term recurrent bleeding risk factor on Cox regression analysis. A performance status score of 3/4 and history of ALGIB were long-term recurrent bleeding factors on competing risk regression analysis. Conclusions: There were no significant differences in outcomes between EDSL and EBL for CDB. After ligation therapy, careful follow-up is required, especially in the treatment of sigmoid diverticular bleeding during admission. History of ALGIB and performance status at admission are important risk factors for long-term recurrent bleeding after discharge.

Original language	English
Pages (from-to)	59-72.e7
Journal	Gastrointestinal endoscopy
Volume	98
Issue number	1
DOIs	https://doi.org/10.1016/j.gie.2023.02.014
Publication status	Published - 07-2023

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Gastroenterology

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10.1016/j.gie.2023.02.014

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Yamauchi, A., Ishii, N., Yamada, A., Kobayashi, K., Omori, J., Ikeya, T., Aoyama, T., Tominaga, N., Sato, Y., Kishino, T., Sawada, T., Murata, M., Takao, A., Mizukami, K., Kinjo, K., Fujimori, S., Uotani, T., Fujita, M., Sato, H., ... Nagata, N. (2023). Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding: a multicenter retrospective cohort study. Gastrointestinal endoscopy, 98(1), 59-72.e7. https://doi.org/10.1016/j.gie.2023.02.014

@article{3848867a8ef84b259a33a6e02d795c6b,

title = "Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding: a multicenter retrospective cohort study",

abstract = "Background and Aims: Ligation therapy, including endoscopic detachable snare ligation (EDSL) and endoscopic band ligation (EBL), has emerged as an endoscopic treatment for colonic diverticular bleeding (CDB); its comparative effectiveness and risk of recurrent bleeding remain unclear, however. Our goal was to compare the outcomes of EDSL and EBL in treating CDB and identify risk factors for recurrent bleeding after ligation therapy. Methods: We reviewed data of 518 patients with CDB who underwent EDSL (n = 77) or EBL (n = 441) in a multicenter cohort study named the Colonic Diverticular Bleeding Leaders Update Evidence From Multicenter Japanese Study (CODE BLUE-J Study). Outcomes were compared by using propensity score matching. Logistic and Cox regression analyses were performed for recurrent bleeding risk, and a competing risk analysis was used to treat death without recurrent bleeding as a competing risk. Results: No significant differences were found between the 2 groups in terms of initial hemostasis, 30-day recurrent bleeding, interventional radiology or surgery requirements, 30-day mortality, blood transfusion volume, length of hospital stay, and adverse events. Sigmoid colon involvement was an independent risk factor for 30-day recurrent bleeding (odds ratio, 1.87; 95% confidence interval, 1.02-3.40; P =.042). History of acute lower GI bleeding (ALGIB) was a significant long-term recurrent bleeding risk factor on Cox regression analysis. A performance status score of 3/4 and history of ALGIB were long-term recurrent bleeding factors on competing risk regression analysis. Conclusions: There were no significant differences in outcomes between EDSL and EBL for CDB. After ligation therapy, careful follow-up is required, especially in the treatment of sigmoid diverticular bleeding during admission. History of ALGIB and performance status at admission are important risk factors for long-term recurrent bleeding after discharge.",

author = "Atsushi Yamauchi and Naoki Ishii and Atsuo Yamada and Katsumasa Kobayashi and Jun Omori and Takashi Ikeya and Taiki Aoyama and Naoyuki Tominaga and Yoshinori Sato and Takaaki Kishino and Tsunaki Sawada and Masaki Murata and Akinari Takao and Kazuhiro Mizukami and Ken Kinjo and Shunji Fujimori and Takahiro Uotani and Minoru Fujita and Hiroki Sato and Sho Suzuki and Toshiaki Narasaka and Junnosuke Hayasaka and Tomohiro Funabiki and Yuzuru Kinjo and Akira Mizuki and Shu Kiyotoki and Tatsuya Mikami and Ryosuke Gushima and Hiroyuki Fujii and Yuta Fuyuno and Naohiko Gunji and Yosuke Toya and Kazuyuki Narimatsu and Noriaki Manabe and Koji Nagaike and Tetsu Kinjo and Yorinobu Sumida and Sadahiro Funakoshi and Kiyonori Kobayashi and Tamotsu Matsuhashi and Yuga Komaki and Kuniko Miki and Kazuhiro Watanabe and Yuki Mori and Kazuki Osawa and Sota Nakagami and Yuya Kawai and Takaaki Yoshikawa and Mitsuru Kaise and Naoyoshi Nagata",

note = "Publisher Copyright: {\textcopyright} 2023 American Society for Gastrointestinal Endoscopy",

year = "2023",

month = jul,

doi = "10.1016/j.gie.2023.02.014",

language = "English",

volume = "98",

pages = "59--72.e7",

journal = "Gastrointestinal endoscopy",

issn = "0016-5107",

publisher = "Elsevier Inc.",

number = "1",

}

Yamauchi, A, Ishii, N, Yamada, A, Kobayashi, K, Omori, J, Ikeya, T, Aoyama, T, Tominaga, N, Sato, Y, Kishino, T, Sawada, T, Murata, M, Takao, A, Mizukami, K, Kinjo, K, Fujimori, S, Uotani, T, Fujita, M, Sato, H, Suzuki, S, Narasaka, T, Hayasaka, J, Funabiki, T, Kinjo, Y, Mizuki, A, Kiyotoki, S, Mikami, T, Gushima, R, Fujii, H, Fuyuno, Y, Gunji, N, Toya, Y, Narimatsu, K, Manabe, N, Nagaike, K, Kinjo, T, Sumida, Y, Funakoshi, S, Kobayashi, K, Matsuhashi, T, Komaki, Y, Miki, K, Watanabe, K, Mori, Y, Osawa, K, Nakagami, S, Kawai, Y, Yoshikawa, T, Kaise, M & Nagata, N 2023, 'Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding: a multicenter retrospective cohort study', Gastrointestinal endoscopy, vol. 98, no. 1, pp. 59-72.e7. https://doi.org/10.1016/j.gie.2023.02.014

TY - JOUR

T1 - Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding

T2 - a multicenter retrospective cohort study

AU - Yamauchi, Atsushi

AU - Ishii, Naoki

AU - Yamada, Atsuo

AU - Kobayashi, Katsumasa

AU - Omori, Jun

AU - Ikeya, Takashi

AU - Aoyama, Taiki

AU - Tominaga, Naoyuki

AU - Sato, Yoshinori

AU - Kishino, Takaaki

AU - Sawada, Tsunaki

AU - Murata, Masaki

AU - Takao, Akinari

AU - Mizukami, Kazuhiro

AU - Kinjo, Ken

AU - Fujimori, Shunji

AU - Uotani, Takahiro

AU - Fujita, Minoru

AU - Sato, Hiroki

AU - Suzuki, Sho

AU - Narasaka, Toshiaki

AU - Hayasaka, Junnosuke

AU - Funabiki, Tomohiro

AU - Kinjo, Yuzuru

AU - Mizuki, Akira

AU - Kiyotoki, Shu

AU - Mikami, Tatsuya

AU - Gushima, Ryosuke

AU - Fujii, Hiroyuki

AU - Fuyuno, Yuta

AU - Gunji, Naohiko

AU - Toya, Yosuke

AU - Narimatsu, Kazuyuki

AU - Manabe, Noriaki

AU - Nagaike, Koji

AU - Kinjo, Tetsu

AU - Sumida, Yorinobu

AU - Funakoshi, Sadahiro

AU - Kobayashi, Kiyonori

AU - Matsuhashi, Tamotsu

AU - Komaki, Yuga

AU - Miki, Kuniko

AU - Watanabe, Kazuhiro

AU - Mori, Yuki

AU - Osawa, Kazuki

AU - Nakagami, Sota

AU - Kawai, Yuya

AU - Yoshikawa, Takaaki

AU - Kaise, Mitsuru

AU - Nagata, Naoyoshi

PY - 2023/7

Y1 - 2023/7

N2 - Background and Aims: Ligation therapy, including endoscopic detachable snare ligation (EDSL) and endoscopic band ligation (EBL), has emerged as an endoscopic treatment for colonic diverticular bleeding (CDB); its comparative effectiveness and risk of recurrent bleeding remain unclear, however. Our goal was to compare the outcomes of EDSL and EBL in treating CDB and identify risk factors for recurrent bleeding after ligation therapy. Methods: We reviewed data of 518 patients with CDB who underwent EDSL (n = 77) or EBL (n = 441) in a multicenter cohort study named the Colonic Diverticular Bleeding Leaders Update Evidence From Multicenter Japanese Study (CODE BLUE-J Study). Outcomes were compared by using propensity score matching. Logistic and Cox regression analyses were performed for recurrent bleeding risk, and a competing risk analysis was used to treat death without recurrent bleeding as a competing risk. Results: No significant differences were found between the 2 groups in terms of initial hemostasis, 30-day recurrent bleeding, interventional radiology or surgery requirements, 30-day mortality, blood transfusion volume, length of hospital stay, and adverse events. Sigmoid colon involvement was an independent risk factor for 30-day recurrent bleeding (odds ratio, 1.87; 95% confidence interval, 1.02-3.40; P =.042). History of acute lower GI bleeding (ALGIB) was a significant long-term recurrent bleeding risk factor on Cox regression analysis. A performance status score of 3/4 and history of ALGIB were long-term recurrent bleeding factors on competing risk regression analysis. Conclusions: There were no significant differences in outcomes between EDSL and EBL for CDB. After ligation therapy, careful follow-up is required, especially in the treatment of sigmoid diverticular bleeding during admission. History of ALGIB and performance status at admission are important risk factors for long-term recurrent bleeding after discharge.

AB - Background and Aims: Ligation therapy, including endoscopic detachable snare ligation (EDSL) and endoscopic band ligation (EBL), has emerged as an endoscopic treatment for colonic diverticular bleeding (CDB); its comparative effectiveness and risk of recurrent bleeding remain unclear, however. Our goal was to compare the outcomes of EDSL and EBL in treating CDB and identify risk factors for recurrent bleeding after ligation therapy. Methods: We reviewed data of 518 patients with CDB who underwent EDSL (n = 77) or EBL (n = 441) in a multicenter cohort study named the Colonic Diverticular Bleeding Leaders Update Evidence From Multicenter Japanese Study (CODE BLUE-J Study). Outcomes were compared by using propensity score matching. Logistic and Cox regression analyses were performed for recurrent bleeding risk, and a competing risk analysis was used to treat death without recurrent bleeding as a competing risk. Results: No significant differences were found between the 2 groups in terms of initial hemostasis, 30-day recurrent bleeding, interventional radiology or surgery requirements, 30-day mortality, blood transfusion volume, length of hospital stay, and adverse events. Sigmoid colon involvement was an independent risk factor for 30-day recurrent bleeding (odds ratio, 1.87; 95% confidence interval, 1.02-3.40; P =.042). History of acute lower GI bleeding (ALGIB) was a significant long-term recurrent bleeding risk factor on Cox regression analysis. A performance status score of 3/4 and history of ALGIB were long-term recurrent bleeding factors on competing risk regression analysis. Conclusions: There were no significant differences in outcomes between EDSL and EBL for CDB. After ligation therapy, careful follow-up is required, especially in the treatment of sigmoid diverticular bleeding during admission. History of ALGIB and performance status at admission are important risk factors for long-term recurrent bleeding after discharge.

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DO - 10.1016/j.gie.2023.02.014

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SN - 0016-5107

VL - 98

SP - 59-72.e7

JO - Gastrointestinal endoscopy

JF - Gastrointestinal endoscopy

IS - 1

ER -

Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding: a multicenter retrospective cohort study

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