Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire study

Ryota Niikura, Naoyoshi Nagata, Hisashi Doyama, Ryosuke Ota, Naoki Ishii, Katsuhiro Mabe, Tsutomu Nishida, Takuto Hikichi, Kazuki Sumiyama, Jun Nishikawa, Toshio Uraoka, Shu Kiyotoki, Mitsuhiro Fujishiro, Kazuhiko Koike, Ryota Niikura, Naoyoshi Nagata, Hisashi Doyama, Ryosuke Ota, Naoki Ishii, Katsuhiro Mabe, Tsutomu Nishida, Takuto Hikichi, Kazuki Sumiyama, Jun Nishikawa, Toshio Uraoka, Shu Kiyotoki, Mitsuhiro Fujishiro, Kazuhiko Koike

Abstract

Aim: To clarify the current state of practice for colonic diverticular bleeding (CDB) in Japan.

Methods: We conducted multicenter questionnaire surveys of the practice for CDB including clinical settings (8 questions), diagnoses (8 questions), treatments (7 questions), and outcomes (4 questions) in 37 hospitals across Japan. The answers were compared between hospitals with high and low number of inpatient beds to investigate which factor influenced the answers.

Results: Endoscopists at all 37 hospitals answered the questions, and the mean number of endoscopists at these hospitals was 12.7. Of all the hospitals, computed tomography was performed before colonoscopy in 67% of the hospitals. The rate of bowel preparation was 46.0%. Early colonoscopy was performed within 24 h in 43.2% of the hospitals. Of the hospitals, 83.8% performed clipping as first-line endoscopic therapy. More than half of the hospitals experienced less than 20% rebleeding events after endoscopic hemostasis. No significant difference was observed in the annual number of patients hospitalized for CDB between high- (≥ 700 beds) and low-volume hospitals. More emergency visits (P = 0.012) and endoscopists (P = 0.015), and less frequent participation of nursing staff in early colonoscopy (P = 0.045) were observed in the high-volume hospitals.

Conclusion: Some practices unique to Japan were found, such as performing computed tomography before colonoscopy, no bowel preparation, and clipping as first-line therapy. Although, the number of staff differed, the practices for CDB were common irrespective of hospital size.

Keywords: Bowel preparation; Colonic diverticular hemorrhage; Computed tomography; Endoscopy; Lower gastrointestinal bleeding.

Conflict of interest statement

Conflict-of-interest statement: Dr. Mitsuhiro Fujishiro has received grant support from Hoya and Pentax.

Figures

Figure 1
Figure 1
Number of beds per hospital in East and West Japan.

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