Long-term outcome of capsule endoscopy in obscure gastrointestinal bleeding: a nationwide analysis

被引：59

作者：

Min, Yang Won ^{[1
]}

Kim, Jin Su ^{[2
]}

Jeon, Seong Woo ^{[3
]}

Jeen, Yoon Tae ^{[4
]}

Im, Jong Pil ^{[5
,6
]}

Cheung, Dae Young ^{[7
]}

Choi, Myung-Gyu ^{[2
]}

Kim, Jin-Oh ^{[8
]}

Lee, Kwang Jae ^{[9
]}

Ye, Byong Duk ^{[10
]}

Shim, Ki-Nam ^{[11
]}

Moon, Jeong Seop ^{[12
]}

Kim, Ji Hyun ^{[13
]}

Hong, Sung Pil ^{[14
]}

Chang, Dong Kyung ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Med, Seoul 135710, South Korea

[2] Catholic Univ, Seoul St Marys Hosp, Coll Med, Seoul 137040, South Korea

[3] Kyungpook Natl Univ Hosp, Taegu, South Korea

[4] Korea Univ Hosp, Seoul, South Korea

[5] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul 151, South Korea

[6] Seoul Natl Univ, Coll Med, Liver Res Inst, Seoul, South Korea

[7] Catholic Univ, Coll Med, Yoido St Marys Hosp, Seoul 137040, South Korea

[8] Soonchunhyang Univ, Seoul, South Korea

[9] Ajou Univ, Sch Med, Ajou Univ Hosp, Dept Gastroenterol, Suwon 441749, South Korea

[10] Univ Ulsan, Coll Med, Asan Med Ctr, Seoul, South Korea

[11] Ewha Womans Univ, Sch Med, Seoul, South Korea

[12] Inje Univ, Seoul Paik Hosp, Seoul, South Korea

[13] Inje Univ, Coll Med, Busan Paik Hosp, Pusan, South Korea

[14] Yonsei Univ, Coll Med, Seoul, South Korea

来源：

ENDOSCOPY | 2014年 / 46卷 / 01期

关键词：

SINGLE-CENTER EXPERIENCE; PUSH ENTEROSCOPY; CONSECUTIVE PATIENTS; DIAGNOSTIC YIELD; CLINICAL IMPACT; VIDEO CAPSULE; SMALL-BOWEL; FOLLOW-UP; STRATEGY;

D O I：

10.1055/s-0033-1358803

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and study aims: The clinical impact of video capsule endoscopy (VCE) in patients with obscure gastrointestinal bleeding (OGIB) remains undetermined. The aim of this study was to evaluate the long-term clinical impact of VCE in patients with OGIB using a nationwide registry. Patients and methods: Data from 305 patients who underwent VCE for OGIB from 13 hospitals in Korea between January 2006 and March 2009 were analyzed. Prospectively collected VCE registry data were reviewed, and follow-up data were collected by chart review and telephone interviews with patients. Multivariate regression analyses using hazard ratios (HR) were performed to determine risk factors for rebleeding. Results: Significant findings were detected in 157 patients (51.5%). After VCE, interventional treatment was performed in 36 patients (11.8%). The overall rebleeding rate was 19.0% during a mean (SD) follow-up of 38.7 +/- 26.4 months. Rebleeding rate did not differ by positive VCE results or application of interventional treatment. Multivariate analysis revealed that angiodysplasia (HR 1.82; 95% confidence interval [CI] 1.04-3.20; P=0.037) and duration of OGIB >3 months (HR 1.64; 95%CI 1.10-2.46; P=0.016) were independent prognostic factors associated with rebleeding. In a subgroup analysis of patients taking anticoagulants, patients who discontinued drugs after VCE showed a lower rebleeding rate than those who did not discontinue this therapy (P=0.019). Conclusions: VCE did not have a significant impact on the long-term outcome of patients with OGIB. Patients with angiodysplasia on VCE or OGIB>3 months need to be closely followed even after interventional treatment. In patients who are taking anticoagulants, discontinuation of drugs is necessary in order to lower the risk of rebleeding.

引用

页码：59 / 65

页数：7

共 33 条

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