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Recent Trends in Treatment for Colonic Diverticular Bleeding in Japan

発表形態:
原著論文
主要業績:
主要業績
単著・共著:
共著
発表年月:
2020年
DOI:
10.1159/000504089
会議属性:
指定なし
査読:
有り
リンク情報:

日本語フィールド

著者:
○Nanae Tsuruoka, Hironobu Takedomi, Yasuhisa Sakata, Ryo Shimoda
題名:
Recent Trends in Treatment for Colonic Diverticular Bleeding in Japan
発表情報:
Digestion 巻: 101 号: 1 ページ: 12-17
キーワード:
概要:
Background: In both Western countries and in Japan, the incidence of colonic diverticular bleeding has increased with increased use of antithrombotic and nonsteroidal anti-inflammatory drugs (NSAIDs). Therefore, the Japan Gastroenterological Association issued guidelines for colonic diverticular bleeding and colonic diverticulitis in Japanese in 2017 and in English in 2019. However, the guidelines contain unresolved problems. Herein, we review the recent treatment trends for colonic diverticular bleeding in Japan. Summary: Colonic diverticular bleeding necessitates frequent blood transfusions due to rebleeding, and patients require prolonged hospitalization. Endoscopic treatment plays an important role in treating diverticular bleeding. Currently, endoscopic band ligation (EBL) and endoscopic clipping are used in Japan for diverticular hemorrhage when the source of the hemorrhage is identified. EBL results in significantly lower early (<30 days) and 1-year rebleeding rates and long-term recurrence rates compared with endoscopic clipping. Furthermore, the proportion of patients requiring transcatheter arterial embolization or surgery after EBL is significantly lower than that following endoscopic clipping. Several reports state that EBL is superior to endoscopic clipping; however, EBL has associated complications, and it is necessary to carefully consider the individual patient. Key Messages: EBL is superior to endoscopic clipping regarding short- and long-term rebleeding rates and the rate of transition to surgery and embolization. Methods for preventing diverticular hemorrhage have not been established, but NSAIDs should be discontinued if possible. Prevention strategies for diverticular bleeding need to be evaluated in studies with large sample sizes.
抄録:

英語フィールド

Author:
○Nanae Tsuruoka, Hironobu Takedomi, Yasuhisa Sakata, Ryo Shimoda
Title:
Recent Trends in Treatment for Colonic Diverticular Bleeding in Japan
Announcement information:
Digestion Vol: 101 Issue: 1 Page: 12-17
An abstract:
Background: In both Western countries and in Japan, the incidence of colonic diverticular bleeding has increased with increased use of antithrombotic and nonsteroidal anti-inflammatory drugs (NSAIDs). Therefore, the Japan Gastroenterological Association issued guidelines for colonic diverticular bleeding and colonic diverticulitis in Japanese in 2017 and in English in 2019. However, the guidelines contain unresolved problems. Herein, we review the recent treatment trends for colonic diverticular bleeding in Japan. Summary: Colonic diverticular bleeding necessitates frequent blood transfusions due to rebleeding, and patients require prolonged hospitalization. Endoscopic treatment plays an important role in treating diverticular bleeding. Currently, endoscopic band ligation (EBL) and endoscopic clipping are used in Japan for diverticular hemorrhage when the source of the hemorrhage is identified. EBL results in significantly lower early (<30 days) and 1-year rebleeding rates and long-term recurrence rates compared with endoscopic clipping. Furthermore, the proportion of patients requiring transcatheter arterial embolization or surgery after EBL is significantly lower than that following endoscopic clipping. Several reports state that EBL is superior to endoscopic clipping; however, EBL has associated complications, and it is necessary to carefully consider the individual patient. Key Messages: EBL is superior to endoscopic clipping regarding short- and long-term rebleeding rates and the rate of transition to surgery and embolization. Methods for preventing diverticular hemorrhage have not been established, but NSAIDs should be discontinued if possible. Prevention strategies for diverticular bleeding need to be evaluated in studies with large sample sizes.


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