Publications by authors named "Shu Kiyotoki"
Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.
Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).
Results: A total of 6575 patients with CDB were included.
Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower gastrointestinal bleeding (ALGIB).
Methods: We analyzed 8,956 patients with ALGIB in CODE BLUE-J study and categorized them into four groups based on BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.
Article Synopsis
- The study examined the link between blood group O and the likelihood of rebleeding in patients with acute lower gastrointestinal bleeding (ALGIB).
- Out of 2336 patients analyzed, those with blood group O had higher rebleeding rates within 30 days (17.9%) and 1 year (21.9%) compared to non-O patients.
- Blood group O was found to be an independent risk factor for rebleeding, while rates of thrombosis and mortality were similar between groups.
Introduction: We investigated the factors associated with synchronous multiple early gastric cancers and determined their localization.
Methods: We analyzed 8,191 patients who underwent endoscopic submucosal dissection for early gastric cancers at 33 hospitals in Japan from November 2013 to October 2016. Background factors were compared between single-lesion (n = 7,221) and synchronous multi-lesion cases (n = 970) using univariate and multivariate analyses.
Article Synopsis
- The study analyzed 8,254 cases of patients with acute lower gastrointestinal bleeding to find key factors that predict mortality and create a reliable prediction tool.
- Researchers established the CACHEXIA score, which uses factors present at admission and management during hospitalization to assess the risk of death within 30 days and 1 year.
- The CACHEXIA score demonstrated high accuracy (ROC-AUC 0.93 for 30 days; C-index 0.88 for 1 year) with significant differentiation of mortality risk, indicating that patients with high scores need continuous monitoring after discharge.
Article Synopsis
- A study analyzed data from 10,342 patients with acute lower gastrointestinal bleeding (ALGIB) to better understand surgical rates, procedures, and outcomes.
- Surgery was performed in only 1.3% of patients, with common indications being diverticular bleeding, colorectal cancer, and small bowel bleeding, and the overall mortality rate was 1.5% for those who underwent surgery.
- The findings suggest that identifying the source of bleeding and using endoscopic techniques may lower the need for surgery and enhance treatment for ALGIB.
Article Synopsis
- This study compared the effects of early versus delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB) after their bleeding was controlled.
- Researchers analyzed data from 5,910 patients across Japan, dividing them into early (feeding within 1 day) and delayed (feeding after 2-3 days) groups.
- Results showed no significant differences in rebleeding rates or need for further treatments between the groups, but the early feeding group had a shorter hospital stay, suggesting it is a safe and beneficial practice.
Article Synopsis
- A study analyzed the impact of weekend admissions on outcomes for patients with acute lower gastrointestinal bleeding in 49 Japanese hospitals from 2010 to 2019.
- The findings showed no significant difference in mortality rates between weekend and weekday admissions, although weekend admissions resulted in a higher need for blood transfusions.
- Additionally, weekend admissions led to delays in early colonoscopy and an increase in urgent CT scans, but overall mortality and other outcomes remained unaffected.
Article Synopsis
- A predictive model called the LONG-HOSP score was developed to assess the risk of prolonged hospital stays for patients admitted with acute lower gastrointestinal bleeding (ALGIB), based on their baseline characteristics.
- The study analyzed data from over 8,500 patients across 49 hospitals to create and validate this model, which includes factors such as age, body mass index, and various lab results.
- Findings revealed that certain conditions and treatments during hospitalization, like colitis diagnosis and early colonoscopy, significantly impacted the length of stay, with early interventions helping to reduce it.
Article Synopsis
- This study compares the effectiveness of short vs. long attachment caps in colonoscopy for identifying causes of acute hematochezia, specifically looking at recent hemorrhage.
- Using data from over 6,400 patients, researchers found that long cap users had significantly higher rates of diagnosing colonic diverticular bleeding and identifying active bleeding, compared to short cap users.
- The conclusion suggests that long cap-assisted colonoscopy is more effective for diagnosing acute hematochezia and recognizing bleeding compared to short caps.
Background: Previous studies have revealed an association between probiotic use and effectiveness of immune checkpoint inhibitors in renal and lung cancers. However, little is known regarding other cancers, including gastrointestinal cancer.
Methods: To address this issue, we conducted a multicenter retrospective cohort study and the duration of nivolumab treatment for various cancers was compared between probiotic users and non-users.
Article Synopsis
- A study analyzed long-term outcomes of 5048 patients hospitalized for acute lower gastrointestinal bleeding (ALGIB) in Japan to understand risks of recurrence after discharge.
- Findings revealed that 25.8% of patients experienced rebleeding within an average follow-up of 31 months, with significant mortality risks increasing for those with out-of-hospital rebleeding episodes.
- Key risk factors for rebleeding included shock index, blood transfusion, in-hospital rebleeding, colonic diverticular bleeding, and thienopyridine use, while endoscopic hemostasis was found to reduce rebleeding risk.
Article Synopsis
- - The study compared the effectiveness of two ligation therapies, endoscopic detachable snare ligation (EDSL) and endoscopic band ligation (EBL), in treating colonic diverticular bleeding (CDB) using data from 518 patients within a multicenter study.
- - Findings revealed no significant differences in outcomes like initial hemostasis, recurrent bleeding within 30 days, mortality, or need for additional interventions between the two treatment groups.
- - Sigmoid colon involvement and a history of acute lower gastrointestinal bleeding (ALGIB) were identified as significant risk factors for long-term recurrent bleeding, emphasizing the need for careful follow-up after ligation therapy.
Article Synopsis
- The study investigates the impact of antiplatelet agents (APAs) on post-endoscopic submucosal dissection (ESD) bleeding risks in early gastric cancer (EGC) patients, focusing on thienopyridine and cilostazol users.
- A total of 9,736 patients were analyzed, revealing that aspirin continuation significantly increased bleeding risk, while other groups (thienopyridine and cilostazol) did not show significant associations with post-ESD bleeding.
- The findings suggest that substituting thienopyridine with aspirin or cilostazol can lower bleeding risks while effectively managing thromboembolism for EGC patients undergoing ESD.
Article Synopsis
- The study investigates angioectasia as a cause of acute hematochezia and identifies significant risk factors such as chronic kidney disease, liver disease, female gender, lower body mass index, and anticoagulant use.
- Among the 10,342 patients analyzed, only 1.2% were diagnosed with angioectasia, with this group experiencing a higher need for blood transfusions and a notable incidence of rebleeding.
- Coagulation therapy was found to significantly reduce rebleeding risk compared to conservative management, indicating its effectiveness in treating patients with angioectasia-related hematochezia.
Introduction: Few studies have focused on bleeding following endoscopic submucosal dissection (ESD) in surgically altered stomach. We aimed to reveal the bleeding risk in surgically altered stomach following ESD for early gastric cancer (EGC).
Methods: We enrolled patients with ESD for EGC at 33 institutions between 2013 and 2016.
Article Synopsis
- The study aimed to find the best timing for colonoscopy in patients with acute lower GI bleeding and to identify factors that could help them.
- Researchers analyzed data from over 6,200 patients who had colonoscopy within 120 hours of bleeding, comparing outcomes based on early (≤24 hours), elective (24-48 hours), and late (48-120 hours) procedures.
- Early colonoscopy led to better identification of recent bleeding and shorter hospital stays but also had a higher rebleeding rate, without affecting mortality or the need for additional interventions; it was especially beneficial for patients with a higher shock index or poor performance status.
Background: The impacts of chemotherapy on patients with malignant gastrointestinal obstructions remain unclear, and multicenter evidence is lacking.
Aim: To evaluate the effectiveness and safety of chemotherapy in patients with unresectable malignant gastrointestinal obstructions.
Methods: We conducted a multicenter retrospective cohort study that compared the chemotherapy group who received any chemotherapeutics after interventions, including palliative surgery or self-expandable metal stent placement, for unresectable malignant gastrointestinal obstruction the best supportive care (BSC) group between 2014 and 2019 in nine hospitals.
Background And Aims: Recent studies have suggested that right- and left-sided colorectal cancers (CRCs) are molecularly distinct. In this study, we examined the association between the risk of right- and left-sided CRC and drug use to estimate their chemopreventive effects METHODS: This multicenter retrospective cohort study was conducted using the data of hospitalized patients between 2014 and 2019 from nine hospital databases. The primary outcomes were right- and left-sided CRC.
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- The study investigates post-endoscopic submucosal dissection (ESD) bleeding in early gastric cancer patients, focusing on the role of gastric mucosal atrophy and Helicobacter pylori infection.
- It analyzed 8,170 patients across 33 hospitals in Japan, revealing that nonsevere gastric mucosal atrophy posed a bleeding risk for H. pylori-negative patients but not for those who were H. pylori-positive.
- The findings suggest that the use of antithrombotic drugs influences bleeding risk, particularly in patients without H. pylori infection.
Background: Direct and indirect clipping treatments are used worldwide to treat colonic diverticular bleeding (CDB), but their effectiveness has not been examined in multicenter studies with more than 100 cases.
Objective: We sought to determine the short- and long-term effectiveness of direct versus indirect clipping for CDB in a nationwide cohort.
Methods: We studied 1041 patients with CDB who underwent direct clipping (n = 360) or indirect clipping (n = 681) at 49 hospitals across Japan (CODE BLUE-J Study).
Background And Aims: Treatment strategies for colonic diverticular bleeding (CDB) based on stigmata of recent hemorrhage (SRH) remain unstandardized, and no large studies have evaluated their effectiveness. We sought to identify the best strategy among combinations of SRH identification and endoscopic treatment strategies.
Methods: We retrospectively analyzed 5823 CDB patients who underwent colonoscopy at 49 hospitals throughout Japan (CODE-BLUE J-Study).
Background: Oesophageal cancer comprises 2 different histological variants: oesophageal squamous-cell carcinoma (ESCC) and adenocarcinoma (EAC). While there are multiple therapeutic options for both types, patients with advanced or metastatic oesophageal cancer still suffer from poor prognosis.
Aims: The study aimed to examine the association between the risk of oesophageal cancer and medications and to estimate the chemopreventive effects of commonly used drugs.
Article Synopsis
- - The text addresses a correction regarding the article with the DOI: 10.1055/a-1464-0809, ensuring that readers have the most accurate information available.
- - It highlights the importance of maintaining precision in academic publications, which can impact research and citation credibility.
- - The correction underlines the ongoing commitment to integrity and accuracy in scholarly communication, aligning with academic standards.