PMID- 34079882
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211020
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 6
DP  - 2021 Jun
TI  - Feasibility and safety of colonoscopy performed by nonexperts for acute lower 
      gastrointestinal bleeding: post hoc analysis.
PG  - E943-E954
LID - 10.1055/a-1464-0809 [doi]
AB  - 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.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Nishida, Tsutomu
AU  - Nishida T
AD  - Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka-shi, Osaka, 
      Japan.
FAU - Nikura, Ryota
AU  - Nikura R
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
AD  - Gastroenterological Endoscopy, Tokyo Medical University, Shinjuku-ku, Tokyo, 
      Japan.
FAU - Nagata, Naoyoshi
AU  - Nagata N
AD  - Gastroenterological Endoscopy, Tokyo Medical University, Shinjuku-ku, Tokyo, 
      Japan.
AD  - Department of Gastroenterology and Hepatology, National Center for Global Health 
      and Medicine, Shinjuku-ku, Tokyo, Japan.
FAU - Honda, Tetsuro
AU  - Honda T
AD  - Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki-shi, 
      Nagasaki, Japan.
FAU - Sunagozaka, Hajime
AU  - Sunagozaka H
AD  - Department of Gastroenterology, Fukui Prefectural Hospital, Fukui-shi, Fukui, 
      Japan.
FAU - Shiratori, Yasutoshi
AU  - Shiratori Y
AD  - Department of Gastroenterology, St. Luke's International Hospital, Chuo-ku, 
      Tokyo, Japan.
FAU - Tsuji, Shigetsugu
AU  - Tsuji S
AD  - Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 
      Kanazawa-shi, Ishikawa, Japan.
FAU - Sumiyoshi, Tetsuya
AU  - Sumiyoshi T
AD  - Department of Gastroenterology, Tonan Hospital, Sapporo-shi, Hokkaido, Japan.
FAU - Fujita, Tomoki
AU  - Fujita T
AD  - Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru-shi, Hokkaido, 
      Japan.
AD  - Department of Gastroenterology, Sapporo Century Hospital, Sapporo-shi, Hokkaido, 
      Japan.
FAU - Kiyotoki, Shu
AU  - Kiyotoki S
AD  - Department of Gastroenterology, Shuto General Hospital, Yanai-shi, Yamaguchi, 
      Japan.
FAU - Yada, Tomoyuki
AU  - Yada T
AD  - Department of Gastroenterology and Hepatology, National Center for Global Health 
      and Medicine Kohnodai Hospital, Ichikawa-shi, Chiba, Japan.
FAU - Yamamoto, Katsumi
AU  - Yamamoto K
AD  - Department of Gastroenterology, Japan Community Healthcare Organization Osaka 
      Hospital, Osaka-shi, Osaka, Japan.
FAU - Shinozaki, Tomohiro
AU  - Shinozaki T
AD  - Department of Information and Computer Technology, Faculty of Engineering, Tokyo 
      University of Science, Tokyo, Japan.
FAU - Nakamatsu, Dai
AU  - Nakamatsu D
AD  - Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka-shi, Osaka, 
      Japan.
FAU - Yamada, Atsuo
AU  - Yamada A
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Fujishiro, Mitsuhiro
AU  - Fujishiro M
AD  - Department of Gastroenterology and Hepatology, Nagoya University Graduate School 
      of Medicine, Nagoya-shi, Aichi, Japan.
LA  - eng
PT  - Journal Article
DEP - 20210527
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
EIN - Endosc Int Open. 2021 Oct 13;9(6):C10. PMID: 34667713
PMC - PMC8159603
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2021/06/04 06:00
MHDA- 2021/06/04 06:01
PMCR- 2021/05/01
CRDT- 2021/06/03 06:44
PHST- 2020/12/15 00:00 [received]
PHST- 2021/03/02 00:00 [accepted]
PHST- 2021/06/03 06:44 [entrez]
PHST- 2021/06/04 06:00 [pubmed]
PHST- 2021/06/04 06:01 [medline]
PHST- 2021/05/01 00:00 [pmc-release]
AID - 10.1055/a-1464-0809 [doi]
PST - ppublish
SO  - Endosc Int Open. 2021 Jun;9(6):E943-E954. doi: 10.1055/a-1464-0809. Epub 2021 May 
      27.