Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis
Background and study aims It remains unclear whether the experience of endoscopists affects clinical outcomes for acute lower gastrointestinal bleeding (ALGIB). We aimed to determine the feasibility and safety of colonoscopies performed by nonexperts using secondary data from a randomized controlled...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2021-05-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1464-0809 |
| _version_ | 1818738482055479296 |
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| author | Tsutomu Nishida Ryota Niikura Naoyoshi Nagata Tetsuro Honda Hajime Sunagozaka Yasutoshi Shiratori Shigetsugu Tsuji Tetsuya Sumiyoshi Tomoki Fujita Shu Kiyotoki Tomoyuki Yada Katsumi Yamamoto Tomohiro Shinozaki Dai Nakamatsu Atsuo Yamada Mitsuhiro Fujishiro |
| author_facet | Tsutomu Nishida Ryota Niikura Naoyoshi Nagata Tetsuro Honda Hajime Sunagozaka Yasutoshi Shiratori Shigetsugu Tsuji Tetsuya Sumiyoshi Tomoki Fujita Shu Kiyotoki Tomoyuki Yada Katsumi Yamamoto Tomohiro Shinozaki Dai Nakamatsu Atsuo Yamada Mitsuhiro Fujishiro |
| author_sort | Tsutomu Nishida |
| collection | DOAJ |
| description | Background and study aims It remains unclear whether the experience of endoscopists affects clinical outcomes for acute lower gastrointestinal bleeding (ALGIB). We aimed to determine the feasibility and safety of colonoscopies performed by nonexperts using secondary data from a randomized controlled trial for ALGIB.
Patients and methods We analyzed clinical outcomes in 159 patients with ALGIB who underwent colonoscopies performed by two groups of endoscopists: experts and nonexperts. We compared endoscopy outcomes, including identification of stigmata of recent hemorrhage (SRH), successful endoscopic treatment, adverse events (AEs), and clinical outcomes between the two groups, including 30-day rebleeding, transfusion, length of stay, thrombotic events, and 30-day mortality.
Results Expert endoscopists alone performed colonoscopies in 96 patients, and nonexperts performed colonoscopies in 63 patients. The use of antiplatelets and warfarin was significantly higher in the expert group. The SRH identification rate (24.0 and 17.5 %), successful endoscopic treatment rate (95.0 and 100 %), rate of AEs during colonoscopy (0 and 0 %), transfusion rate (6.3 and 4.8 %), length of stay (8.0 and 6.4 days), rate of thrombotic events (0 and 1.8 %), and mortality (0 and 0 %) were not different between the expert and nonexpert groups. Rebleeding within 30 days occurred more often in the expert group than in the nonexpert group (14.3 vs. 5.4 % P = 0.0914).
Conclusions The performance of colonoscopies for ALGIB by nonexperts did not result in worse clinical outcomes, suggesting that its use could be feasible for nonexperts for diagnosis and treatment of ALGIB. |
| first_indexed | 2024-12-18T01:09:38Z |
| format | Article |
| id | doaj.art-e012fbca98554a18a32593e28e7a52b1 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-18T01:09:38Z |
| publishDate | 2021-05-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-e012fbca98554a18a32593e28e7a52b12022-12-21T21:26:09ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362021-05-010906E943E95410.1055/a-1464-0809Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysisTsutomu Nishida0Ryota Niikura1Naoyoshi Nagata2Tetsuro Honda3Hajime Sunagozaka4Yasutoshi Shiratori5Shigetsugu Tsuji6Tetsuya Sumiyoshi7Tomoki Fujita8Shu Kiyotoki9Tomoyuki Yada10Katsumi Yamamoto11Tomohiro Shinozaki12Dai Nakamatsu13Atsuo Yamada14Mitsuhiro Fujishiro15Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka-shi, Osaka, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanGastroenterological Endoscopy, Tokyo Medical University, Shinjuku-ku, Tokyo, JapanDepartment of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki-shi, Nagasaki, JapanDepartment of Gastroenterology, Fukui Prefectural Hospital, Fukui-shi, Fukui, JapanDepartment of Gastroenterology, St. Luke's International Hospital, Chuo-ku, Tokyo, JapanDepartment of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa-shi, Ishikawa, JapanDepartment of Gastroenterology, Tonan Hospital, Sapporo-shi, Hokkaido, JapanDepartment of Gastroenterology, Otaru Ekisaikai Hospital, Otaru-shi, Hokkaido, JapanDepartment of Gastroenterology, Shuto General Hospital, Yanai-shi, Yamaguchi, JapanDepartment of Gastroenterology and Hepatology, National Center for Global Health and Medicine Kohnodai Hospital, Ichikawa-shi, Chiba, JapanDepartment of Gastroenterology, Japan Community Healthcare Organization Osaka Hospital, Osaka-shi, Osaka, JapanDepartment of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, JapanDepartment of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka-shi, Osaka, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya-shi, Aichi, JapanBackground and study aims It remains unclear whether the experience of endoscopists affects clinical outcomes for acute lower gastrointestinal bleeding (ALGIB). We aimed to determine the feasibility and safety of colonoscopies performed by nonexperts using secondary data from a randomized controlled trial for ALGIB. Patients and methods We analyzed clinical outcomes in 159 patients with ALGIB who underwent colonoscopies performed by two groups of endoscopists: experts and nonexperts. We compared endoscopy outcomes, including identification of stigmata of recent hemorrhage (SRH), successful endoscopic treatment, adverse events (AEs), and clinical outcomes between the two groups, including 30-day rebleeding, transfusion, length of stay, thrombotic events, and 30-day mortality. Results Expert endoscopists alone performed colonoscopies in 96 patients, and nonexperts performed colonoscopies in 63 patients. The use of antiplatelets and warfarin was significantly higher in the expert group. The SRH identification rate (24.0 and 17.5 %), successful endoscopic treatment rate (95.0 and 100 %), rate of AEs during colonoscopy (0 and 0 %), transfusion rate (6.3 and 4.8 %), length of stay (8.0 and 6.4 days), rate of thrombotic events (0 and 1.8 %), and mortality (0 and 0 %) were not different between the expert and nonexpert groups. Rebleeding within 30 days occurred more often in the expert group than in the nonexpert group (14.3 vs. 5.4 % P = 0.0914). Conclusions The performance of colonoscopies for ALGIB by nonexperts did not result in worse clinical outcomes, suggesting that its use could be feasible for nonexperts for diagnosis and treatment of ALGIB.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1464-0809 |
| spellingShingle | Tsutomu Nishida Ryota Niikura Naoyoshi Nagata Tetsuro Honda Hajime Sunagozaka Yasutoshi Shiratori Shigetsugu Tsuji Tetsuya Sumiyoshi Tomoki Fujita Shu Kiyotoki Tomoyuki Yada Katsumi Yamamoto Tomohiro Shinozaki Dai Nakamatsu Atsuo Yamada Mitsuhiro Fujishiro Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis Endoscopy International Open |
| title | Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis |
| title_full | Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis |
| title_fullStr | Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis |
| title_full_unstemmed | Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis |
| title_short | Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis |
| title_sort | feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding post hoc analysis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1464-0809 |
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