Endoscopy 2020; 52(S 01): S44-S45
DOI: 10.1055/s-0040-1704136
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 14:30 – 16:00 Twist and shout through the bowel Liffey Meeting Room 1
© Georg Thieme Verlag KG Stuttgart · New York

A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS OF RISK FACTORS FOR REBLEEDING FOLLOWING DEVICE-ASSISTED ENTEROSCOPY THERAPY OF SMALL-BOWEL VASCULAR LESIONS

E Pérez-Cuadrado-Robles
1   Georges Pompidou European Hospital, Gastroenterology, Paris, France
,
G Perrod
1   Georges Pompidou European Hospital, Gastroenterology, Paris, France
,
T Moreels
2   Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Gastroenterology, Bruxelles, Belgium
,
LEZ Nava
3   National Institute of Medical Sciences and Nutrition Salvador Zubirán, Gastroenterology, Mexico, Mexico
,
G Blanco
4   Instituto Mexicano del Seguro Social, Gastroenterology, Mexico, Mexico
,
PE Delgado
5   Hospital Morales Meseguer, Gastroenterology, Murcia, Spain
,
E Samaha
6   Hotel Dieu de France, Gastroenterology, Beirut, Lebanon
,
OVH Mondragón
4   Instituto Mexicano del Seguro Social, Gastroenterology, Mexico, Mexico
,
G Rahmi
1   Georges Pompidou European Hospital, Gastroenterology, Paris, France
,
C Cellier
1   Georges Pompidou European Hospital, Gastroenterology, Paris, France
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims To determine the risk factors for rebleeding following device-assisted enteroscopy therapy of small bowel vascular lesions.

Methods This is a systematic review and meta-analysis. A literature search was conducted from January 2003 to October 2019. All studies reporting on at least one risk factor for bleeding recurrence after endoscopic therapy of small bowel vascular lesions were included. A meta-analysis for those risk factors reported in at least 3 studies was done to assess their association with rebleeding. For binary outcome data, the OR and 95%CIs were used. Heterogeneity analysis was performed using the Tau and I2 index. If I2 >20%, potential sources of heterogeneity were identified by sensitivity analyses and a random-effect model was used.

Results The search identified a total of 572 articles and 35 full-text records were assessed for eligibility after screening. Finally, 8 studies including 548 patients were included. The overall median rebleeding rate was 38.5% (range: 10.9-53.3%) with a median follow-up of 24.5 months.

Female sex [OR: 1.96, 95%CI: 1.14-3.37, p=0.01, I2=0%], Osler-Weber syndrome [OR: 4.35, 95%CI: 1.22-15.45, p=0.02, I2=0%] and cardiac disease [OR: 1.89, 95%CI: 1.12-2.97, p=0.005, I2: 0%] were associated with rebleeding. By sensitivity analysis, overt bleeding [OR: 2.13, 95%CI: 1.22-3.70, p=0.007, I2=0%], multiple lesions [OR: 4.60, 95%CI: 2.06-10.28, p< 0.001, I2=0%] and liver cirrhosis [OR: 0.22, 95%CI: 0.02-0.42, p=0.03, I2=0%] were also predictors of this outcome.

Conclusions Patient’s characteristics and comorbidities should be considered in patients who undergo device-assisted endoscopic therapy, as they can predict the rebleeding.