Evidence map›Paper›PMID 41180987›Full record

ArticleWorld journal of gastroenterology2025

Minimum colonoscopy observation time for colonic diverticular bleeding: A new benchmark based on the 5% plateau time.

Chikamasa Ichita, Tadahiro Goto, Takashi Nishino, Soichiro Nakaya, Sayuri Shimizu

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PubMed Full text at PMC Publisher
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Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Chikamasa IchitaGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Kanagawa, Japan.
Tadahiro GotoDepartment of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama 236-0027, Kanagawa, Japan.
Takashi NishinoGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Kanagawa, Japan.
Soichiro NakayaGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Kanagawa, Japan.
Sayuri ShimizuDepartment of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama 236-0027, Kanagawa, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundColonic diverticular bleeding (CDB) is a leading cause of gastrointestinal bleeding-related hospitalizations in Japan and is increasingly recognized as a significant burden in the United States. Identifying the stigmata of a recent hemorrhage (SRH) during colonoscopy enables targeted hemostasis and reduces rebleeding. However, no benchmark exists for an appropriate observation duration, resulting in operator-dependent variation. Short observation periods may lead to missed SRH, whereas unnecessarily prolonged procedures, particularly in older patients, can increase patient burden and limit endoscopy unit availability.

aimTo establish a practical benchmark for minimum colonoscopy observation time to ensure reliable SRH detection in patients with CDB.

methodsWe retrospectively analyzed patients with acute hematochezia who underwent an initial colonoscopy between January 2017 and December 2024 at a Japanese tertiary hospital. The Observation time was measured from scope insertion to SRH detection (excluding therapeutic time) or withdrawal. The primary outcome, the "5% plateau time", was defined as the point when the proportion of patients newly identified with SRH in each 5-minute interval consistently dropped below 5%. Computed tomography (CT)-based stratified analyses were performed by endoscopists who conducted ≥ 10% of procedures.

resultsOf the 1039 patients who underwent colonoscopy, 845 (mean age 77 ± 11 years; 64.5% male) were included. Nine board-certified endoscopists performed the procedures. SRH was detected in 286 patients (33.8%), with a median detection time of 19 minutes (interquartile range, 12-28 minutes). The overall 5% plateau time was 40 minutes and varied according to the CT findings: 40, 35, and 30 minutes for no extravasation, right-sided extravasation, and left-sided extravasation, respectively. This time point corresponded to when 80%-90% of SRH cases were detected. Despite variations in SRH detection rates and observation durations among endoscopists, the 5% plateau time was consistently approximately 40 minutes.

conclusionAlthough it varied according to the CT findings, the overall 5% plateau time was 40 minutes. This offers a practical benchmark for the minimum observation time without SRH detection.

Indexed as

BenchmarkingColonoscopyDiverticulum, ColonGastrointestinal HemorrhageAgedAged, 80 and overColonFemaleHemostasis, EndoscopicHumansJapanMaleMiddle AgedRetrospective StudiesTime FactorsTomography, X-Ray ComputedBleeding sourceDiverticular hemorrhageLower gastrointestinal bleedingObservation durationObservation timeStigmata of recent hemorrhageWithdraw time

Identifiers

PMID41180987
PMCPMC12576556

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.