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Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire
Ryota Niikura1, Naoyoshi Nagata1, Hisashi Doyama1
1Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
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.
