Anticoagulation Resumption After Colonic Polypectomy: Predicting Prime Post-procedural Timing

Excerpt

Colonoscopic detection and removal of adenomas reduces colorectal cancer incidence and associated mortality [1]. Though colonoscopy is considered a safe procedure, it is associated with a risk of bleeding when polypectomy is performed. Though the risk of post-polypectomy bleeding (PPB) is 1% in patients without risk factors [2], it is 1.8–8% in patients receiving antiplatelet or anticoagulation therapy [3]. Other factors that can influence the risk of PPB include comorbidities such as renal and cardiovascular disease, polyp size and morphology, and polypectomy technique [4]. For instance, in patients requiring complex resections with techniques such as wide-field endoscopic mucosal resection, the risk of bleeding was reported to be 6.2%, with repeat colonoscopy required in half of the patients [5]. Importantly, the highest bleeding risk is present within 48 h of the initial polypectomy. …