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• W2081567013 abstract "Introduction: Capsule endoscopy (CE) allows complete visualization of the small bowel. It has a high diagnostic yield in patients with obscure gastrointestinal bleeding (OGIB). Its immediate clinical impact -meaning its capacity to induce therapeutic and diagnostic decision making- is from 25 to 43%. However it is unknown its long term impact over recurrent bleeding in patients with identified lesions and a prescribed specific treatment. Objective: Study the long term impact of CE over recurrent bleeding in patients with OGIB. Patients and Methods: Patients with OGIB were selected, in whom CE was practiced in a period longer than 6 months prior to the inclusion in the study. Diagnostic yield (finding of any lesion) and its immediate clinical impact (capacity to induce therapeutic procedures) were established. Long term impact over recurrent bleeding was estimated by means of the Kaplan-Meier method. Differences about frequency of rebleeding between groups were analyzed by Chi square test. Results: 33 patients were included, 17 female and 16 male. Median age was 53 yr (18-87 yr), median follow up was 15 months (6-20 months). Diagnostic yield was 82% (27/33). The most frequent diagnostic findings included: angiodysplasias (12 patients); ulcers (9 patients); and neoplasia (6 patients). Group 1 was composed of 13 patients who received specific treatment: surgical 8 and endoscopic 5 (immediate clinical impact 39%). Group 2 was composed of 20 patients, 14 with positive CE and no treatment and 6 with negative CE. At the end of follow up, only 1 patient from Group 1 and 7 from Group 2 presented recurrent bleeding. Difference of cumulative probability of recurrent bleeding between both groups became significant after 15 months of follow up (0% vs 33%, p = 0.016). Furthermore at 20 months the cumulative probability of rebleeding was 8% in Group 1 vs 60% in Group 2 (p = 0.043). Neither patient managed surgically had rebleeding. Conclusions: The CE diagnostic yield was 82% and the immediate clinical impact 39%. At 20 months of follow up, CE had a favorable influence in patients with specific treatment as it had significantly reduced recurrent bleeding by 52%. This difference became significant after 15 months follow up. The high frequency of rebleeding in patients with positive and negative CE without specific treatment shows the need for complementary diagnostic and therapeutic procedures, such as double balloon enteroscopy or surgery." @default.
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• W2081567013 date "2006-04-01" @default.
• W2081567013 modified "2023-10-17" @default.
• W2081567013 title "Capsule Endoscopy Has a Long Term Impact Over Recurrent Bleeding in Patients with Obscure Gastrointestinal Bleeding" @default.
• W2081567013 doi "https://doi.org/10.1016/j.gie.2006.03.650" @default.
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