Efficacy of routine second-look endoscopy after endoscopic hemostasis in patients with acute peptic ulcer bleeding: systematic review and meta-analysis
DOI:
https://doi.org/10.47892/rgp.2024.442.1623Keywords:
Endoscopy, Gastrointestinal hemorrhage, Meta-analysisAbstract
Objective: To evaluate the efficacy of scheduled second-look endoscopy in patients with acute peptic ulcer bleeding (PUB). Materials and methods: We systematically search in four databases for randomized controlled trials (RCTs) that evaluated the usefulness of scheduled second-look endoscopy vs. single endoscopy in patients with PUB. Our primary outcome was rebleeding. Secondary outcomes were surgery, mortality, and the number of units of blood transfused (NUBT). All meta-analyses were performed using a randomeffects model. Pooled risk ratio (RR) and mean difference (MD), with their 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and the quality of evidence (QoE) was rated with the GRADE approach. Results: Eight full-text RCTs and two RCT abstracts were included (n=1513). We did not find differences in rebleeding (RR, 0.78; 95% CI, 0.53-1.14, moderate QoE), surgery (RR, 0.58; 95% CI, 0.29-1.15, moderate QoE), mortality (RR, 0.89; 95% CI, 0.46-1.71, moderate QoE) or NUBT (MD, -0.01 units; 95% CI, -0.3 to 0.28, low QoE) between second-look and single endoscopy. Sensitivity analyses had similar results to the main analyses. Conclusions: Routine second-look endoscopy was not more efficacious than single endoscopy in patients with PUB.
Downloads
Metrics
References
Wuerth BA, Rockey DC. Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Dig Dis Sci. 2018;63(5):1286-1293. doi: 10.1007/s10620-017-4882-6.
Gralnek IM, Stanley AJ, Morris AJ, Camus M, Lau J, Lanas A, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021. Endoscopy. 2021;53(03):300-332. doi: 10.1055/a-1369-5274.
Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol. 2021;116(5):899-917. doi: 10.14309/ajg.0000000000001245.
Hong MJ, Lee SY, Kim JH, Sung IK, Park HS, Shim CS, et al. Rebleeding after Initial Endoscopic Hemostasis in Peptic Ulcer Disease. J Korean Med Sci. 2014;29(10):1411. doi: 10.3346/jkms.2014.29.10.1411.
Saeed ZA. Second Thoughts about Second-Look Endoscopy For Ulcer Bleeding? Endoscopy. 1998;30(07):650-652. doi: 10.1055/s-2007-1001369.
Kamal F, Khan MA, Lee-Smith W, Sharma S, Imam Z, Henry C, et al. Role of routine second-look endoscopy in patients with acute peptic ulcer bleeding: meta-analysis of randomized controlled trials. Gastrointest Endosc. 2021;93(6):1228-1237.e5. doi: 10.1016/j.gie.2020.12.039.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019:366:l4898. doi: 10.1136/bmj.l4898.
Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011 Apr;64(4):401-6. doi: 10.1016/j.jclinepi.2010.07.015.
Villanueva C, Balanzó J, Torras X, Soriano G, Sáinz S, Vilardell F. Value of second-look endoscopy after injection therapy for bleeding peptic ulcer: A prospective and randomized trial. Gastrointest Endosc. 1994;40(1):34-39. doi: 10.1016/S0016-5107(94)70006-0.
Saeed ZA, Cole RA, Ramirez FC, Schneider FE, Hepps KS, Graham DY. Endoscopic Retreatment After Successful Initial Hemostasis Prevents Ulcer Rebleeding: A Prospective Randomized Trial. Endoscopy. 1996;28(03):288-294. doi: 10.1055/s-2007-1005455.
Messmann H, Schaller P, Andus T, Lock G, Vogt W, Gross V, et al. Effect of Programmed Endoscopic Follow-up Examinations on the Rebleeding Rate of Gastric or Duodenal Peptic Ulcers Treated by Injection Therapy: A Prospective, Randomized Controlled Trial. Endoscopy. 1998;30(07):583-589. doi: 10.1055/s-2007-1001360.
Chiu PWY. Effect of scheduled second therapeutic endoscopy on peptic ulcer rebleeding: a prospective randomised trial. Gut. 2003;52(10):1403-1407. doi: 10.1136/gut.52.10.1403.
Chiu PW, Joeng HK, Choi CL, Tsoi KK, Kwong KH, Lam SH, et al. High-dose omeprazole infusion compared with scheduled second-look endoscopy for prevention of peptic ulcer rebleeding: a randomized controlled trial. Endoscopy. 2016;48(08):717-722. doi: 10.1055/s-0042-107590.
Belei O, Olariu L, Puiu M, Jinca C, Dehelean C, Marcovici T, et al. Continuous esomeprazole infusion versus bolus administration and second look endoscopy for the prevention of rebleeding in children with a peptic ulcer. Rev Esp Enferm Dig. 2018;110. doi: 10.17235/reed.2018.4864/2017.
Park SJ, Park H, Lee YC, Choi CH, Jeon TJ, Park JC, et al. Effect of scheduled second-look endoscopy on peptic ulcer bleeding: a prospective randomized multicenter trial. Gastrointest Endosc. 2018;87(2):457-465. doi: 10.1016/j.gie.2017.07.024.
Pittayanon R, Suen BY, Kongtub N, Tse Y kit, Rerknimitr R, Lau JYW. Scheduled second look endoscopy after endoscopic hemostasis to patients with high risk bleeding peptic ulcers: a Randomized Controlled Trial. Surg Endosc. 2022;36(9):6497-6506. doi: 10.1007/s00464-021-09004-w.
Lin C, Lo G, Cheng J, et al. The value of second-look endoscopy after endoscopic injection therapy for bleeding peptic ulcer [abstract]. Gastroenterology. 1996;110:A177.
Lee S, Cho C, Tak W, et al. The effect of second look endoscopy in patients with bleeding peptic ulcers [abstract]. Gastroenterology. 2005;128:A639.
Imperiale TF, Kong N. Second-look Endoscopy for Bleeding Peptic Ulcer Disease: A Decision-effectiveness and Cost-effectiveness Analysis. J Clin Gastroenterol. 2012;46(9):e71-5. doi: 10.1097/MCG.0b013e3182410351.
El Ouali S, Barkun AN, Wyse J, Romagnuolo J, Sung JJ, Gralnek IM, et al. Is routine second-look endoscopy effective after endoscopic hemostasis in acute peptic ulcer bleeding? A meta-analysis. Gastrointest Endosc. 2012;76(2):283-292. doi: 10.1016/j.gie.2012.04.441.
Jiang M, Chen P, Gao Q. Systematic Review and Net-Work Meta-Analysis of Upper Gastrointestinal Hemorrhage Interventions. Cell Physiol Biochem. 2016;39(6):2477-2491. doi: 10.1159/000452515.
Zhang YS. Proton pump inhibitors therapy vs H 2 receptor antagonists therapy for upper gastrointestinal bleeding after endoscopy: A meta-analysis. World J Gastroenterol. 2015;21(20):6341. doi: 10.3748/wjg.v21.i20.6341.
Green FW, Kaplan MM, Curtis LE, Levine PH. Effect of acid and pepsin on blood coagulation and platelet aggregation. A possible contributor prolonged gastroduodenal mucosal hemorrhage. Gastroenterology. 1978;74(1):38-43.
Chaimoff C, Creter D, Djaldetti M. The effect of pH on platelet and coagulation factor activities. The Am J Surg. 1978;136(2):257-259. doi: 10.1016/0002-9610(78)90241-6.
Sachar H, Vaidya K, Laine L. Intermittent vs Continuous Proton Pump Inhibitor Therapy for High-Risk Bleeding Ulcers: A Systematic Review and Meta-analysis. JAMA Intern Med. 2014;174(11):1755. doi: 10.1001/jamainternmed.2014.4056.
Kim SB, Lee SH, Kim KO, Jang BI, Kim TN, Jeon SW, et al. Risk Factors Associated with Rebleeding in Patients with High Risk Peptic Ulcer Bleeding: Focusing on the Role of Second Look Endoscopy. Dig Dis Sci. 2016;61(2):517-522. doi: 10.1007/s10620-015-3846-y.
Villaescusa Arenas D, Rodríguez De Santiago E, Rodríguez Gandía MÁ, et al. Over the scope clip (OTSC) as rescue treatment for gastrointestinal bleeding secondary to peptic ulcer disease. Rev Esp Enferm Dig. 2023;115(2):70-74. doi: 10.17235/reed.2022.8722/2022.
Rodríguez De Santiago E, Burgos-Santamaría D, Pérez-Carazo L, et al. Hemostatic spray powder TC-325 for GI bleeding in a nationwide study: survival and predictors of failure via competing risks analysis. Gastrointest Endosc. 2019;90(4):581-590.e6. doi: 10.1016/j.gie.2019.06.008.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Harold Benites-Goñi, Jessica Alférez-Andía, Alejandro Piscoya, Carlos Diaz-Arocutipa, Adrian V. Hernandez
This work is licensed under a Creative Commons Attribution 4.0 International License.
Revista de Gastroenterología del Perú by Sociedad Peruana de Gastroenterología del Perú is licensed under a Licencia Creative Commons Atribución 4.0 Internacional..
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
2022 