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; G Perrod; T Moreels; LEZ Nava; G Blanco; PE Delgado; E Samaha; OVH Mondragón; G Rahmi; C Cellier

doi:10.1055/s-0040-1704136

Endoscopy, Table of Contents

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

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

Authors

E Pérez-Cuadrado-Robles

¹Georges Pompidou European Hospital, Gastroenterology, Paris, France
G Perrod

¹Georges Pompidou European Hospital, Gastroenterology, Paris, France
T Moreels

²Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Gastroenterology, Bruxelles, Belgium
LEZ Nava

³National Institute of Medical Sciences and Nutrition Salvador Zubirán, Gastroenterology, Mexico, Mexico
G Blanco

⁴Instituto Mexicano del Seguro Social, Gastroenterology, Mexico, Mexico
PE Delgado

⁵Hospital Morales Meseguer, Gastroenterology, Murcia, Spain
E Samaha

⁶Hotel Dieu de France, Gastroenterology, Beirut, Lebanon
OVH Mondragón

⁴Instituto Mexicano del Seguro Social, Gastroenterology, Mexico, Mexico
G Rahmi

¹Georges Pompidou European Hospital, Gastroenterology, Paris, France
C Cellier

¹Georges Pompidou European Hospital, Gastroenterology, Paris, France

Abstract

Full Text

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.