title: Long-Term Clinical Course after Conservative and Endoscopic Treatment of Colonic Diverticular Bleeding.
abstract: OBJECTIVE
  What naturally happens to patients after they undergo conservative and endoscopic treatment of colonic diverticular bleeding (CDB) is largely unknown. We retrospectively track the long-term outcome of the recurrence of CDB between patients with endoscopic and conservative treatment.
  
  
  METHODS
  The group was divided into 2 groups: patients treated with injection and/or clipping (endoscopic group) and patients in whom such treatment could not be performed (conservative group). CDB recurrence was assessed via a questionnaire, and recurrence rates were investigated between groups using the Kaplan-Meier's method. The Cox proportional hazards model was performed to identify potential risk factors for recurrence.
  
  
  RESULTS
  Eighty-eight patients answered the questionnaires. The median (interquartile range) follow-up period was 42.7 (61.8) months. Twenty-four (38.7%) of 62 conservatively treated patients and 16 (61.5%) of 26 endoscopically treated patients experienced recurrence of CDB during the follow-up period. Kaplan-Meier's analysis showed that the rate of recurrence was significantly higher (p < 0.05) in cases with endoscopic treatment than in those with conservative treatment (mean time to recurrence = 55.3 months (95% CI 30.8-79.9) vs. 99.9 months (95%CI 80.7-119.1)). The Cox proportional hazards model did not identify any significant variables.
  
  
  CONCLUSIONS
  We should carefully follow-up patients to check for the recurrence of CDB, even when it could be successfully treated endoscopically. Can endoscopic treatment of CDB prevent CDB recurrence? Also, what happens to the patient's well-being after they undergo conservative and endoscopic treatment (cases diagnosed by Jensen's criteria) is largely unknown. We examined a population of patients undergoing conservative or endoscopic treatment to clarify the clinical course, particularly with regard to CDB recurrence.
authors.affiliation: Department of Internal Medicine, Keiyu Hospital, Yokohama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Mizuki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tatemichi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakazawa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagata
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D004241:Diverticulum, Colon / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome