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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 6/2014

01-06-2014 | Editorial

Prophylactic Use of Endoclips Post-polypectomy: To Bleed or Not to Bleed?

Author: Hugh James Freeman

Published in: Digestive Diseases and Sciences | Issue 6/2014

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Excerpt

In recent decades, colonoscopic methods have enabled complete endoscopic excision of benign and malignant colonic polyps [1, 2]. Removal of even sessile or depressed colon neoplastic lesions by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) is now possible, as is management of complications including post-polypectomy bleeding. Specific “polyp factors” (e.g., large polyp size over 2 cm) and “patient factors” (e.g., anticoagulant use) can increase bleeding risk at the time of polyp resection as well as the risk for subsequent or delayed bleeding, sometimes reported to develop days to weeks later [3, 4]. …
Literature
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Freeman HJ. Long-term follow-up of patients with malignant pedunculated colon polyps after colonscopic polypectomy. Can J Gastroenterol. 2013;27:20–24.PubMedCentralPubMed
2.
Su MY, Hsu CM, Ho YP, et al. Endoscopic mucosal resection for colonic non-polypoid neoplasms. Am J Gastroenterol. 2005;100:2174–2179.PubMedCrossRef
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Hui AJ, Wong RM, Ching JY, Hung LC, Chung SC, Sung JJ. Risk of colonoscopic polypectomy bleeding with anticoagulants and antiplatelet agents: analysis of 1657 cases. Gastrointest Endosc. 2004;59:44–48.PubMedCrossRef
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Watabe H, Yamaji Y, Okamoto M, et al. Risk assessment for delayed hemorrhagic complication of colonic polypectomy: polyp-related factors and patient-related factors. Gastrointest Endosc. 2006;64:73–78.PubMedCrossRef
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Parra-Blanco A, Kaminaga N, et al. Hemoclipping for postpolypectomy and postbiopsy colonic bleeding. Gastrointest Endosc. 2000;51:37–41.PubMedCrossRef
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Feagins LA, Nguyen AD, Iqbal R, Spechler SJ. The prophylactic placement of hemoclips to prevent delayed post-polypectomy bleeding: an unnecessary practice? A case control study. Dig Dis Sci. 2014;59:823–828.
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Shioji K, Suzuki Y, Kobayashi M, et al. Prophylactic clip application does not decrease delayed bleeding after colonoscopic polypectomy. Gastrointest Endosc. 2003;57:691–694.PubMedCrossRef
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Quintanilla E, Castro JL, Rabago LR, et al. Is the use of prophylactic hemoclips in the endoscopic resection of large pedunculated polyps useful? A prospective and randomized study. J Interv Gastroenterol. 2012;2:183–188.PubMedCentralPubMedCrossRef
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Liaquat H, Rohn E, Rex DK. Prophylactic clip closure reduced the risk of postpolypectomy hemorrhage: experience in 277 clipped large sessile or flat colorectal lesions and 247 control lesions. Gastrointest Endosc. 2013;77:401–407.PubMedCrossRef
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Parikh ND, Zanocco K, Keswani RN, Gawron AJ. A cost-efficacy decision analysis of prophylactic clip placement after endoscopic removal of large polyps. Clin Gastroenterol Hepatol. 2013;11:1319–1324.PubMedCrossRef
Metadata
Title
Prophylactic Use of Endoclips Post-polypectomy: To Bleed or Not to Bleed?
Author
Hugh James Freeman
Publication date
01-06-2014
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 6/2014
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-014-3162-y

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