The effect of prophylactic hemoclip placement and risk factors of delayed post-polypectomy bleeding in polyps sized 6 to 20 millimeters: a propensity score matching analysis

BMC Gastroenterology

Malcolm R. Alison¹  Siew-Na Lim²  Puo-Hsien Le³  Chun-Jung Lin³  Chun-Wei Chen³  Chia-Jung Kuo³  Cheng-Tang Chiu⁴  Ming-Yao Su⁵  Wey-Ran Lin⁶  Chau-Ting Yeh⁶ 

[1] Barts Cancer Institute, Queen Mary University of London, London, UK;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan;Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, No 5, Fu Hsing Street, Guishan Dist., 333, Taoyuan, Taiwan;Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, No 5, Fu Hsing Street, Guishan Dist., 333, Taoyuan, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, No 5, Fu Hsing Street, Guishan Dist., 333, Taoyuan, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Gastroenterology and Hepatology, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan;Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, No 5, Fu Hsing Street, Guishan Dist., 333, Taoyuan, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan;

关键词: Polypectomy;    Delayed post-polypectomy bleeding;    Hemoclip;    Colon polyp;   

DOI  :  10.1186/s12876-020-01454-1

来源: Springer

【 摘 要 】

BackgroundDelayed post-polypectomy bleeding (PPB) is a major complication of polypectomy. The effect of prophylactic hemoclipping on delayed PPB is uncertain. The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB.MethodsPatients with polyps sized 6 to 20 mm underwent snare polypectomy from 2015 to 2017 were retrospectively reviewed. The patients with prophylactic hemoclipping for delayed PPB prevention were included in the clipping group, and those without prophylactic hemoclipping were included in the non-clipping group.The incidence of delayed PPB and time to bleeding were compared between the groups. Multivariate analysis was used to identify the risk factors of delayed PPB. Propensity score matching was used to minimize potential bias.ResultsAfter propensity score matching, 612 patients with 806 polyps were in the clipping group, and 576 patients with 806 polyps were in the non-clipping group. There were no significant differences in the incidence of delayed PPB and days to bleeding between two groups (0.8% vs 1.3%, p = 0.4; 3.4 ± 1.94 days vs 4.13 ± 3.39 days, p = 0.94). In the multivariate analysis, the polyp size [Odds ratio (OR):1.16, 95% confidence interval (CI):1.01–1.16, p = 0.03), multiple polypectomies (OR: 4.64, 95% CI:1.24–17.44, p = 0.02) and a history of anticoagulant use (OR:37.52, 95% CI:6.49–216.8, p < 0.001) were associated with delayed PPB.ConclusionsIn polyps sized 6 to 20 mm, prophylactic hemoclip placement did not decrease the risk of delayed PPB. Patients without risk factors including multiple polypectomies and anticoagulant use are no need to performing prophylactic hemoclipping.

【 授权许可】

CC BY