Published in:
28-06-2021 | Anticoagulant | Original Article
Risk Factors of Delayed Bleeding After Cold Snare Polypectomy for Colorectal Polyps: A Multicenter Study
Authors:
Yoshikazu Inagaki, Naohisa Yoshida, Kohei Fukumoto, Kyoichi Kassai, Ken Inoue, Ryohei Hirose, Osamu Dohi, Takashi Okuda, Daisuke Hasegawa, Kotaro Okuda, Kiyoshi Ogiso, Takayuki Motoyoshi, Hiroyuki Yoriki, Takaaki Murakami, Yoshito Itoh
Published in:
Digestive Diseases and Sciences
|
Issue 7/2022
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Abstract
Background
Delayed bleeding (DB) rarely occurs after cold snare polypectomy (CSP) for colorectal polyps, but no large-scale studies have investigated this. The present study evaluated the rate, characteristics, and risk factors of DB of CSP.
Methods
We conducted a multicenter retrospective study at 10 Japanese institutions. A total of 18,007 patients underwent CSP for colorectal polyps ≤ 10 mm in size from March 2015 to September 2019, and cases of DB (DB group) were analyzed for the rate, antithrombotic drugs, polyp size, morphology, location, and risk factors. As a control, 269 non-bleeding cases (non-DB group) with 606 polyps who underwent CSP at the same 10 facilities in the 2-week study period were extracted.
Results
We analyzed 26 DB cases with 28 lesions, and the total DB rate was 0.14% (26/18,007). The DB group had significantly higher rates of using antiplatelets (42.3% vs. 13.0%, p < 0.001) and anticoagulants (19.2% vs. 2.6%, p = 0.002), and significantly higher rates of polyp size ≥ 5 mm (67.9% vs. 45.2%, p = 0.015), rectal lesion (25.0% vs. 6.6%, p = 0.003), and polypoid lesion (89.3% vs. 55.3%, p < 0.001) than the non-DB group. A multivariate analysis (odds ratio; 95% confidence interval) for patient characteristics showed antiplatelet use (4.521; 1.817–11.249, p = 0.001) and anticoagulant use (7.866; 20.63–29.988, p = 0.003) as independent risk factors for DB. Polyp size ≥ 5 mm (3.251; 1.417–7.463, p = 0.005), rectal lesion (3.674; 1.426–9.465, p = 0.007), and polypoid lesion (7.087; 20.81–24.132, p = 0.002) were also risk factors for lesion characteristics.
Conclusions
The rate of DB was 0.14% and antithrombotic drug use, polyp size, location, and morphology were related to it.