JGH Open (Jul 2023)
Multicenter propensity score‐matched analysis comparing short versus long cap‐assisted colonoscopy for acute hematochezia
- Mariko Kobayashi,
- Shintaro Akiyama,
- Toshiaki Narasaka,
- Katsumasa Kobayashi,
- Atsushi Yamauchi,
- Atsuo Yamada,
- Jun Omori,
- Takashi Ikeya,
- Taiki Aoyama,
- Naoyuki Tominaga,
- Yoshinori Sato,
- Takaaki Kishino,
- Naoki Ishii,
- Tsunaki Sawada,
- Masaki Murata,
- Akinari Takao,
- Kazuhiro Mizukami,
- Ken Kinjo,
- Shunji Fujimori,
- Takahiro Uotani,
- Minoru Fujita,
- Hiroki Sato,
- Sho Suzuki,
- Junnosuke Hayasaka,
- Tomohiro Funabiki,
- Yuzuru Kinjo,
- Akira Mizuki,
- Shu Kiyotoki,
- Tatsuya Mikami,
- Ryosuke Gushima,
- Hiroyuki Fujii,
- Yuta Fuyuno,
- Naohiko Gunji,
- Yosuke Toya,
- Kazuyuki Narimatsu,
- Noriaki Manabe,
- Koji Nagaike,
- Tetsu Kinjo,
- Yorinobu Sumida,
- Sadahiro Funakoshi,
- Kiyonori Kobayashi,
- Tamotsu Matsuhashi,
- Yuga Komaki,
- Kiichiro Tsuchiya,
- Mitsuru Kaise,
- Naoyoshi Nagata
Affiliations
- Mariko Kobayashi
- Division of Endoscopic Center University of Tsukuba Hospital Tsukuba Japan
- Shintaro Akiyama
- Department of Gastroenterology University of Tsukuba Tsukuba Japan
- Toshiaki Narasaka
- Division of Endoscopic Center University of Tsukuba Hospital Tsukuba Japan
- Katsumasa Kobayashi
- Department of Gastroenterology Tokyo Metropolitan Bokutoh Hospital Tokyo Japan
- Atsushi Yamauchi
- Department of Gastroenterology and Hepatology Kitano Hospital, Tazuke Kofukai Medical Research Institute Osaka Japan
- Atsuo Yamada
- Department of Gastroenterology Graduate School of Medicine, The University of Tokyo Tokyo Japan
- Jun Omori
- Department of Gastroenterology Nippon Medical School, Graduate School of Medicine Tokyo Japan
- Takashi Ikeya
- Department of Gastroenterology St. Luke's International University Tokyo Japan
- Taiki Aoyama
- Department of Gastroenterology Hiroshima City Asa Citizens Hospital Hiroshima Japan
- Naoyuki Tominaga
- Department of Gastroenterology Saga‐Ken Medical Centre Koseikan Saga Japan
- Yoshinori Sato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine St Marianna University School of Medicine Kawasaki Japan
- Takaaki Kishino
- Department of Gastroenterology and Hepatology, Center for Digestive and Liver Diseases Nara City Hospital Nara Japan
- Naoki Ishii
- Department of Gastroenterology Tokyo Shinagawa Hospital Tokyo Japan
- Tsunaki Sawada
- Department of Endoscopy Nagoya University Hospital Nagoya Japan
- Masaki Murata
- Department of Gastroenterology National Hospital Organization Kyoto Medical Center Kyoto Japan
- Akinari Takao
- Department of Gastroenterology Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan
- Kazuhiro Mizukami
- Department of Gastroenterology Oita University Oita Japan
- Ken Kinjo
- Department of Gastroenterology Fukuoka University Chikushi Hospital Fukuoka Japan
- Shunji Fujimori
- Department of Gastroenterology Chiba Hokusoh Hospital, Nippon Medical School Chiba Japan
- Takahiro Uotani
- Department of Gastroenterology Japanese Red Cross Shizuoka Hospital Shizuoka Japan
- Minoru Fujita
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine Kawasaki Medical School General Medical Center Okayama Japan
- Hiroki Sato
- Division of Gastroenterology Graduate School of Medical and Dental Sciences, Niigata University Niigata Japan
- Sho Suzuki
- Department of Gastroenterology and Hepatology, Center for Digestive Disease and Division of Endoscopy University of Miyazaki Hospital Miyazaki Japan
- Junnosuke Hayasaka
- Department of Gastroenterology Toranomon Hospital Tokyo Japan
- Tomohiro Funabiki
- Department of Emergency Medicine Fujita Health University Hospital Toyoake Japan
- Yuzuru Kinjo
- Department of Gastroenterology Naha City Hospital Naha Japan
- Akira Mizuki
- Department of Internal Medicine Tokyo Saiseikai Central Hospital Tokyo Japan
- Shu Kiyotoki
- Department of Gastroenterology Shuto General Hospital Yanai‐shi Japan
- Tatsuya Mikami
- Division of Endoscopy Hirosaki University Hospital Hirosaki Japan
- Ryosuke Gushima
- Department of Gastroenterology and Hepatology Graduate School of Medical Sciences, Kumamoto University Kumamoto Japan
- Hiroyuki Fujii
- Department of Gastroenterology and Hepatology National Hospital Organization Fukuokahigashi Medical Center Koga Japan
- Yuta Fuyuno
- Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan
- Naohiko Gunji
- Department of Gastroenterology Fukushima Medical University Fukushima Japan
- Yosuke Toya
- Division of Gastroenterology, Department of Internal Medicine Iwate Medical University Morioka Japan
- Kazuyuki Narimatsu
- Department of Internal Medicine National Defense Medical College Tokorozawa Japan
- Noriaki Manabe
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine Kawasaki Medical School Kurashiki Japan
- Koji Nagaike
- Department of Gastroenterology and Hepatology Suita Municipal Hospital Suita Japan
- Tetsu Kinjo
- Department of Endoscopy University of the Ryukyus Hospital Nishihara Japan
- Yorinobu Sumida
- Department of Gastroenterology National Hospital Organization Kyushu Medical Center Fukuoka Japan
- Sadahiro Funakoshi
- Department of Gastroenterological Endoscopy Fukuoka University Hospital Fukuoka Japan
- Kiyonori Kobayashi
- Department of Gastroenterology Kitasato University, School of Medicine Sagamihara Japan
- Tamotsu Matsuhashi
- Department of Gastroenterology and Neurology Akita University Graduate School of Medicine Akita Japan
- Yuga Komaki
- Digestive and Lifestyle Diseases, and Hygiene and Health Promotion Medicine Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan
- Kiichiro Tsuchiya
- Department of Gastroenterology University of Tsukuba Tsukuba Japan
- Mitsuru Kaise
- Department of Gastroenterology Nippon Medical School, Graduate School of Medicine Tokyo Japan
- Naoyoshi Nagata
- Department of Gastroenterological Endoscopy Tokyo Medical University Tokyo Japan
- DOI
- https://doi.org/10.1002/jgh3.12936
- Journal volume & issue
-
Vol. 7,
no. 7
pp. 487 – 496
Abstract
Abstract Background and Aim While short and long attachment caps are available for colonoscopy, it is unclear which type is more appropriate for stigmata of recent hemorrhage (SRH) identification in acute hematochezia. This study aimed to compare the performance of short versus long caps in acute hematochezia diagnoses and outcomes. Methods We selected 6460 patients who underwent colonoscopy with attachment caps from 10 342 acute hematochezia cases in the CODE BLUE‐J study. We performed propensity score matching (PSM) to balance baseline characteristics between short and long cap users. Then, the proportion of definitive or presumptive bleeding etiologies found on the initial colonoscopy and SRH identification rates were compared. We also evaluated rates of blood transfusions, interventional radiology, or surgery, as well as the rate of rebleeding and mortality within 30 days after the initial colonoscopy. Results A total of 3098 patients with acute hematochezia (1549 short cap and 1549 long cap users) were selected for PSM. The rate of colonic diverticular bleeding (CDB) diagnosis was significantly higher in long cap users (P = 0.006). While the two groups had similar rates of the other bleeding etiologies, the frequency of unknown etiologies was significantly lower in long cap users (P < 0.001). The rate of SRH with active bleeding was significantly higher in long cap users (P < 0.001). Other clinical outcomes did not differ significantly. Conclusion Compared to that with short caps, long cap‐assisted colonoscopy is superior for the diagnosis of acute hematochezia, especially CDB, and the identification of active bleeding.
Keywords
- acute hematochezia
- attachment cap
- cap‐assisted colonoscopy
- colonic diverticular bleeding
- stigmata of recent hemorrhage
