Clinical outcomes of endoscopic detachable snare ligation for colonic diverticular hemorrhage: Multicenter cohort study
Objectives The hemostatic mechanism of endoscopic detachable snare ligation (EDSL) for colonic diverticular hemorrhage (CDH) is similar to that of endoscopic band ligation, which is effective and safe. However, because reports on EDSL are scarce, we conducted a two‐center cohort study to evaluate it...
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| Veröffentlicht in: | Digestive endoscopy 2024-12, Vol.36 (12), p.1357-1366 |
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| creator | Kobayashi, Katsumasa Miura, Natsuki Furumoto, Yohei Ito, Kenji Iseki, Mari Kobayashi, Ryohei Yamada, Yurina Oshina, Eri Arai, Katsuhiro Matsuoka, Mana Nozaka, Takahito Sato, Ayako Yauchi, Masato Matsumoto, Taichi Asano, Toru Namiki, Shin Azuma, Seishin |
| description | Objectives
The hemostatic mechanism of endoscopic detachable snare ligation (EDSL) for colonic diverticular hemorrhage (CDH) is similar to that of endoscopic band ligation, which is effective and safe. However, because reports on EDSL are scarce, we conducted a two‐center cohort study to evaluate its effectiveness.
Methods
This study analyzed 283 patients with CDH treated with EDSL at two Japanese hospitals between July 2015 and November 2021. Patient characteristics and clinical outcomes were retrospectively evaluated. A Kaplan–Meier analysis was performed to evaluate the cumulative probability of rebleeding after EDSL. A Cox proportional hazards regression analysis was performed to compare the effects of complete and incomplete ligation on rebleeding.
Results
The initial hemostasis success and early rebleeding rates were 97.9% and 11.0%, respectively. The time to hemostasis after identification of the bleeding site and total procedure time were 9 min and 44 min, respectively. Red blood cell transfusion was required for 32.9% of patients. The median hospital length of stay after EDSL was 5 days. The complete ligation rate of the early rebleeding group was significantly lower than that of the group without early rebleeding (P |
| doi_str_mv | 10.1111/den.14874 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3076019469</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3076019469</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2854-56d8461ea963226f85b3e7a15e809b6c3c58699b29a076c7861f94c92c1ad80a3</originalsourceid><addsrcrecordid>eNp1kD1PwzAQQC0EoqUw8AeQRxjS2ont2myolA-pwAJz5DiX1siJi51Q9d-TUmDDy0nWu6fTQ-ickjHt36SEZkyZnLIDNKSMZQkVgh6iIVGUJ1xkfIBOYnwnhKaKsWM0yKQSXDA-RJuZs4012mHftcbXELGvMDSlj8avrcEltNqsdOEAx0YHwM4udWt9gysfsPHONzvKfkJoremcDngFtQ9hpZdwjZ86139D08IOXvnQ4th25fYUHVXaRTj7mSP0djd_nT0ki5f7x9nNIjGp5Kw_vpRMUNBKZGkqKsmLDKaacpBEFcJkhkuhVJEqTabCTKWglWJGpYbqUhKdjdDl3rsO_qOD2Oa1jQac0w34LuZZv0aoYkL16NUeNcHHGKDK18HWOmxzSvJd57zvnH937tmLH21X1FD-kb9he2CyBzbWwfZ_U347f94rvwCBNoj7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3076019469</pqid></control><display><type>article</type><title>Clinical outcomes of endoscopic detachable snare ligation for colonic diverticular hemorrhage: Multicenter cohort study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kobayashi, Katsumasa ; Miura, Natsuki ; Furumoto, Yohei ; Ito, Kenji ; Iseki, Mari ; Kobayashi, Ryohei ; Yamada, Yurina ; Oshina, Eri ; Arai, Katsuhiro ; Matsuoka, Mana ; Nozaka, Takahito ; Sato, Ayako ; Yauchi, Masato ; Matsumoto, Taichi ; Asano, Toru ; Namiki, Shin ; Azuma, Seishin</creator><creatorcontrib>Kobayashi, Katsumasa ; Miura, Natsuki ; Furumoto, Yohei ; Ito, Kenji ; Iseki, Mari ; Kobayashi, Ryohei ; Yamada, Yurina ; Oshina, Eri ; Arai, Katsuhiro ; Matsuoka, Mana ; Nozaka, Takahito ; Sato, Ayako ; Yauchi, Masato ; Matsumoto, Taichi ; Asano, Toru ; Namiki, Shin ; Azuma, Seishin</creatorcontrib><description>Objectives
The hemostatic mechanism of endoscopic detachable snare ligation (EDSL) for colonic diverticular hemorrhage (CDH) is similar to that of endoscopic band ligation, which is effective and safe. However, because reports on EDSL are scarce, we conducted a two‐center cohort study to evaluate its effectiveness.
Methods
This study analyzed 283 patients with CDH treated with EDSL at two Japanese hospitals between July 2015 and November 2021. Patient characteristics and clinical outcomes were retrospectively evaluated. A Kaplan–Meier analysis was performed to evaluate the cumulative probability of rebleeding after EDSL. A Cox proportional hazards regression analysis was performed to compare the effects of complete and incomplete ligation on rebleeding.
Results
The initial hemostasis success and early rebleeding rates were 97.9% and 11.0%, respectively. The time to hemostasis after identification of the bleeding site and total procedure time were 9 min and 44 min, respectively. Red blood cell transfusion was required for 32.9% of patients. The median hospital length of stay after EDSL was 5 days. The complete ligation rate of the early rebleeding group was significantly lower than that of the group without early rebleeding (P < 0.01). The 1‐year cumulative rebleeding rate with EDSL was 28.2%. Complete ligation was associated with decreased cumulative rebleeding after EDSL (P < 0.01). One patient experienced colonic diverticulitis; however, colonic perforation was not observed.
Conclusion
Complete ligation is associated with reduced short‐term and long‐term rebleeding. EDSL could be valuable for CDH because of its low rebleeding rate and the absence of serious adverse events.</description><identifier>ISSN: 0915-5635</identifier><identifier>ISSN: 1443-1661</identifier><identifier>EISSN: 1443-1661</identifier><identifier>DOI: 10.1111/den.14874</identifier><identifier>PMID: 38965645</identifier><language>eng</language><publisher>Australia</publisher><subject>acute lower gastrointestinal bleeding ; Aged ; Aged, 80 and over ; Cohort Studies ; colonic diverticular bleeding ; Colonoscopy - methods ; Diverticulum, Colon - complications ; Diverticulum, Colon - surgery ; endoscopic detachable snare ligation ; endoscopic hemostasis ; Female ; Gastrointestinal Hemorrhage - etiology ; Gastrointestinal Hemorrhage - surgery ; Hemostasis, Endoscopic - methods ; Humans ; Japan ; Ligation - methods ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Digestive endoscopy, 2024-12, Vol.36 (12), p.1357-1366</ispartof><rights>2024 Japan Gastroenterological Endoscopy Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2854-56d8461ea963226f85b3e7a15e809b6c3c58699b29a076c7861f94c92c1ad80a3</cites><orcidid>0000-0001-7692-0557 ; 0000-0002-3213-6936</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fden.14874$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fden.14874$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38965645$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kobayashi, Katsumasa</creatorcontrib><creatorcontrib>Miura, Natsuki</creatorcontrib><creatorcontrib>Furumoto, Yohei</creatorcontrib><creatorcontrib>Ito, Kenji</creatorcontrib><creatorcontrib>Iseki, Mari</creatorcontrib><creatorcontrib>Kobayashi, Ryohei</creatorcontrib><creatorcontrib>Yamada, Yurina</creatorcontrib><creatorcontrib>Oshina, Eri</creatorcontrib><creatorcontrib>Arai, Katsuhiro</creatorcontrib><creatorcontrib>Matsuoka, Mana</creatorcontrib><creatorcontrib>Nozaka, Takahito</creatorcontrib><creatorcontrib>Sato, Ayako</creatorcontrib><creatorcontrib>Yauchi, Masato</creatorcontrib><creatorcontrib>Matsumoto, Taichi</creatorcontrib><creatorcontrib>Asano, Toru</creatorcontrib><creatorcontrib>Namiki, Shin</creatorcontrib><creatorcontrib>Azuma, Seishin</creatorcontrib><title>Clinical outcomes of endoscopic detachable snare ligation for colonic diverticular hemorrhage: Multicenter cohort study</title><title>Digestive endoscopy</title><addtitle>Dig Endosc</addtitle><description>Objectives
The hemostatic mechanism of endoscopic detachable snare ligation (EDSL) for colonic diverticular hemorrhage (CDH) is similar to that of endoscopic band ligation, which is effective and safe. However, because reports on EDSL are scarce, we conducted a two‐center cohort study to evaluate its effectiveness.
Methods
This study analyzed 283 patients with CDH treated with EDSL at two Japanese hospitals between July 2015 and November 2021. Patient characteristics and clinical outcomes were retrospectively evaluated. A Kaplan–Meier analysis was performed to evaluate the cumulative probability of rebleeding after EDSL. A Cox proportional hazards regression analysis was performed to compare the effects of complete and incomplete ligation on rebleeding.
Results
The initial hemostasis success and early rebleeding rates were 97.9% and 11.0%, respectively. The time to hemostasis after identification of the bleeding site and total procedure time were 9 min and 44 min, respectively. Red blood cell transfusion was required for 32.9% of patients. The median hospital length of stay after EDSL was 5 days. The complete ligation rate of the early rebleeding group was significantly lower than that of the group without early rebleeding (P < 0.01). The 1‐year cumulative rebleeding rate with EDSL was 28.2%. Complete ligation was associated with decreased cumulative rebleeding after EDSL (P < 0.01). One patient experienced colonic diverticulitis; however, colonic perforation was not observed.
Conclusion
Complete ligation is associated with reduced short‐term and long‐term rebleeding. EDSL could be valuable for CDH because of its low rebleeding rate and the absence of serious adverse events.</description><subject>acute lower gastrointestinal bleeding</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort Studies</subject><subject>colonic diverticular bleeding</subject><subject>Colonoscopy - methods</subject><subject>Diverticulum, Colon - complications</subject><subject>Diverticulum, Colon - surgery</subject><subject>endoscopic detachable snare ligation</subject><subject>endoscopic hemostasis</subject><subject>Female</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>Gastrointestinal Hemorrhage - surgery</subject><subject>Hemostasis, Endoscopic - methods</subject><subject>Humans</subject><subject>Japan</subject><subject>Ligation - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0915-5635</issn><issn>1443-1661</issn><issn>1443-1661</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kD1PwzAQQC0EoqUw8AeQRxjS2ont2myolA-pwAJz5DiX1siJi51Q9d-TUmDDy0nWu6fTQ-ickjHt36SEZkyZnLIDNKSMZQkVgh6iIVGUJ1xkfIBOYnwnhKaKsWM0yKQSXDA-RJuZs4012mHftcbXELGvMDSlj8avrcEltNqsdOEAx0YHwM4udWt9gysfsPHONzvKfkJoremcDngFtQ9hpZdwjZ86139D08IOXvnQ4th25fYUHVXaRTj7mSP0djd_nT0ki5f7x9nNIjGp5Kw_vpRMUNBKZGkqKsmLDKaacpBEFcJkhkuhVJEqTabCTKWglWJGpYbqUhKdjdDl3rsO_qOD2Oa1jQac0w34LuZZv0aoYkL16NUeNcHHGKDK18HWOmxzSvJd57zvnH937tmLH21X1FD-kb9he2CyBzbWwfZ_U347f94rvwCBNoj7</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Kobayashi, Katsumasa</creator><creator>Miura, Natsuki</creator><creator>Furumoto, Yohei</creator><creator>Ito, Kenji</creator><creator>Iseki, Mari</creator><creator>Kobayashi, Ryohei</creator><creator>Yamada, Yurina</creator><creator>Oshina, Eri</creator><creator>Arai, Katsuhiro</creator><creator>Matsuoka, Mana</creator><creator>Nozaka, Takahito</creator><creator>Sato, Ayako</creator><creator>Yauchi, Masato</creator><creator>Matsumoto, Taichi</creator><creator>Asano, Toru</creator><creator>Namiki, Shin</creator><creator>Azuma, Seishin</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7692-0557</orcidid><orcidid>https://orcid.org/0000-0002-3213-6936</orcidid></search><sort><creationdate>202412</creationdate><title>Clinical outcomes of endoscopic detachable snare ligation for colonic diverticular hemorrhage: Multicenter cohort study</title><author>Kobayashi, Katsumasa ; Miura, Natsuki ; Furumoto, Yohei ; Ito, Kenji ; Iseki, Mari ; Kobayashi, Ryohei ; Yamada, Yurina ; Oshina, Eri ; Arai, Katsuhiro ; Matsuoka, Mana ; Nozaka, Takahito ; Sato, Ayako ; Yauchi, Masato ; Matsumoto, Taichi ; Asano, Toru ; Namiki, Shin ; Azuma, Seishin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2854-56d8461ea963226f85b3e7a15e809b6c3c58699b29a076c7861f94c92c1ad80a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>acute lower gastrointestinal bleeding</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort Studies</topic><topic>colonic diverticular bleeding</topic><topic>Colonoscopy - methods</topic><topic>Diverticulum, Colon - complications</topic><topic>Diverticulum, Colon - surgery</topic><topic>endoscopic detachable snare ligation</topic><topic>endoscopic hemostasis</topic><topic>Female</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Gastrointestinal Hemorrhage - surgery</topic><topic>Hemostasis, Endoscopic - methods</topic><topic>Humans</topic><topic>Japan</topic><topic>Ligation - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kobayashi, Katsumasa</creatorcontrib><creatorcontrib>Miura, Natsuki</creatorcontrib><creatorcontrib>Furumoto, Yohei</creatorcontrib><creatorcontrib>Ito, Kenji</creatorcontrib><creatorcontrib>Iseki, Mari</creatorcontrib><creatorcontrib>Kobayashi, Ryohei</creatorcontrib><creatorcontrib>Yamada, Yurina</creatorcontrib><creatorcontrib>Oshina, Eri</creatorcontrib><creatorcontrib>Arai, Katsuhiro</creatorcontrib><creatorcontrib>Matsuoka, Mana</creatorcontrib><creatorcontrib>Nozaka, Takahito</creatorcontrib><creatorcontrib>Sato, Ayako</creatorcontrib><creatorcontrib>Yauchi, Masato</creatorcontrib><creatorcontrib>Matsumoto, Taichi</creatorcontrib><creatorcontrib>Asano, Toru</creatorcontrib><creatorcontrib>Namiki, Shin</creatorcontrib><creatorcontrib>Azuma, Seishin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kobayashi, Katsumasa</au><au>Miura, Natsuki</au><au>Furumoto, Yohei</au><au>Ito, Kenji</au><au>Iseki, Mari</au><au>Kobayashi, Ryohei</au><au>Yamada, Yurina</au><au>Oshina, Eri</au><au>Arai, Katsuhiro</au><au>Matsuoka, Mana</au><au>Nozaka, Takahito</au><au>Sato, Ayako</au><au>Yauchi, Masato</au><au>Matsumoto, Taichi</au><au>Asano, Toru</au><au>Namiki, Shin</au><au>Azuma, Seishin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes of endoscopic detachable snare ligation for colonic diverticular hemorrhage: Multicenter cohort study</atitle><jtitle>Digestive endoscopy</jtitle><addtitle>Dig Endosc</addtitle><date>2024-12</date><risdate>2024</risdate><volume>36</volume><issue>12</issue><spage>1357</spage><epage>1366</epage><pages>1357-1366</pages><issn>0915-5635</issn><issn>1443-1661</issn><eissn>1443-1661</eissn><abstract>Objectives
The hemostatic mechanism of endoscopic detachable snare ligation (EDSL) for colonic diverticular hemorrhage (CDH) is similar to that of endoscopic band ligation, which is effective and safe. However, because reports on EDSL are scarce, we conducted a two‐center cohort study to evaluate its effectiveness.
Methods
This study analyzed 283 patients with CDH treated with EDSL at two Japanese hospitals between July 2015 and November 2021. Patient characteristics and clinical outcomes were retrospectively evaluated. A Kaplan–Meier analysis was performed to evaluate the cumulative probability of rebleeding after EDSL. A Cox proportional hazards regression analysis was performed to compare the effects of complete and incomplete ligation on rebleeding.
Results
The initial hemostasis success and early rebleeding rates were 97.9% and 11.0%, respectively. The time to hemostasis after identification of the bleeding site and total procedure time were 9 min and 44 min, respectively. Red blood cell transfusion was required for 32.9% of patients. The median hospital length of stay after EDSL was 5 days. The complete ligation rate of the early rebleeding group was significantly lower than that of the group without early rebleeding (P < 0.01). The 1‐year cumulative rebleeding rate with EDSL was 28.2%. Complete ligation was associated with decreased cumulative rebleeding after EDSL (P < 0.01). One patient experienced colonic diverticulitis; however, colonic perforation was not observed.
Conclusion
Complete ligation is associated with reduced short‐term and long‐term rebleeding. EDSL could be valuable for CDH because of its low rebleeding rate and the absence of serious adverse events.</abstract><cop>Australia</cop><pmid>38965645</pmid><doi>10.1111/den.14874</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-7692-0557</orcidid><orcidid>https://orcid.org/0000-0002-3213-6936</orcidid></addata></record> |
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| subjects | acute lower gastrointestinal bleeding Aged Aged, 80 and over Cohort Studies colonic diverticular bleeding Colonoscopy - methods Diverticulum, Colon - complications Diverticulum, Colon - surgery endoscopic detachable snare ligation endoscopic hemostasis Female Gastrointestinal Hemorrhage - etiology Gastrointestinal Hemorrhage - surgery Hemostasis, Endoscopic - methods Humans Japan Ligation - methods Male Middle Aged Recurrence Retrospective Studies Treatment Outcome |
| title | Clinical outcomes of endoscopic detachable snare ligation for colonic diverticular hemorrhage: Multicenter cohort study |
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