title: Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire study.
abstract: OBJECTIVE
  To clarify the current state of practice for colonic diverticular bleeding (CDB) in Japan.
  
  
  METHODS
  We conducted multicenter questionnaire surveys of the practice for CDB including clinical settings (8 questions), diagnoses (8 questions), treatments (7 questions), and outcomes (4 questions) in 37 hospitals across Japan. The answers were compared between hospitals with high and low number of inpatient beds to investigate which factor influenced the answers.
  
  
  RESULTS
  Endoscopists at all 37 hospitals answered the questions, and the mean number of endoscopists at these hospitals was 12.7. Of all the hospitals, computed tomography was performed before colonoscopy in 67% of the hospitals. The rate of bowel preparation was 46.0%. Early colonoscopy was performed within 24 h in 43.2% of the hospitals. Of the hospitals, 83.8% performed clipping as first-line endoscopic therapy. More than half of the hospitals experienced less than 20% rebleeding events after endoscopic hemostasis. No significant difference was observed in the annual number of patients hospitalized for CDB between high- (≥ 700 beds) and low-volume hospitals. More emergency visits (P= 0.012) and endoscopists (P= 0.015), and less frequent participation of nursing staff in early colonoscopy (P= 0.045) were observed in the high-volume hospitals.
  
  
  CONCLUSIONS
  Some practices unique to Japan were found, such as performing computed tomography before colonoscopy, no bowel preparation, and clipping as first-line therapy. Although, the number of staff differed, the practices for CDB were common irrespective of hospital size.
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Niikura
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Nagata
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Doyama
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ota
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Mabe
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sumiyama
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nishikawa
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Uraoka
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Kiyotoki
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.affiliation: Ryota Niikura, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
keywords: Bowel preparation; Colonic diverticular hemorrhage; Computed tomography; Endoscopy; Lower gastrointestinal bleeding