Favorable long-term outcomes of repeat endotherapy for small-intestine vascular lesions by double-balloon endoscopy.
Gastrointest Endosc
; 80(1): 112-7, 2014 Jul.
Article
em En
| MEDLINE
| ID: mdl-24444670
ABSTRACT
BACKGROUND:
GI bleeding secondary to small-intestine vascular lesions (SIVLs) is associated with rebleeding despite initial hemostasis by endotherapy applied at double-balloon endoscopy (DBE).OBJECTIVE:
To evaluate the long-term outcomes of DBE endotherapy of SIVL (as described by the Yano-Yamamoto classification). The impact of repeat DBE endotherapy for recurrent bleeding also was assessed.DESIGN:
Retrospective cohort study. The mean (± standard deviation [SD]) follow-up period was 4.9 (± 1.7) years (range 2.4-9.1 years).SETTING:
Tertiary-care referral center. PATIENTS A total of 43 patients, who underwent 69 sessions of DBE endotherapy of SIVLs. INTERVENTION DBE endotherapy. MAIN OUTCOME MEASUREMENTS Frequency of overt rebleeding after the initial DBE endotherapy.RESULTS:
Overt rebleeding occurred in 16 of 43 patients (37%). Patients with multiple SIVLs showed a significantly higher rate of overt rebleeding than did those with a solitary SIVL (12/23 [52%] vs 4/20 [20%]; P = .017). The trend toward frequency of rebleeding after the first DBE hemostasis appeared to be higher for patients with type 1a SIVLs than for those with type 1b or type 2 lesions type 1a (8/16, 50%) versus type 1b (5/19, 26%) (P = .12) and type 1a (8/16, 50%) versus type 2 (2/7, 29%) (P = .31), respectively. In 12 of 16 patients (75%) who underwent repeat DBE endotherapy at each episode of overt rebleeding (median 3 times, range 2-6), the frequency of rebleeding decreased significantly after the first year of follow-up, as compared with the remaining 4 patients who did not undergo repeat DBE; mean (± SD) 0.12 (± 0.19) versus 0.52 (± 0.33) times per year per patient (P = .006).LIMITATIONS:
Single-center, retrospective study.CONCLUSION:
Although the presence of multiple SIVLs was associated with rebleeding, repeat DBE endotherapy resulted in an improved long-term outcome in patients with refractory SIVL bleeding.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Hemostase Endoscópica
/
Enteroscopia de Duplo Balão
/
Hemorragia Gastrointestinal
/
Intestino Delgado
Tipo de estudo:
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Japão