The effect of prophylactic hemoclip placement and risk factors of delayed post-polypectomy bleeding in polyps sized 6 to
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RESEARCH ARTICLE
Open Access
The effect of prophylactic hemoclip placement and risk factors of delayed postpolypectomy bleeding in polyps sized 6 to 20 millimeters: a propensity score matching analysis Chun-Wei Chen1, Chia-Jung Kuo1, Cheng-Tang Chiu1,2, Ming-Yao Su1,2,3, Chun-Jung Lin1, Puo-Hsien Le1, Siew-Na Lim2,4, Chau-Ting Yeh1,2,5, Malcolm R. Alison6 and Wey-Ran Lin1,2,5*
Abstract Background: Delayed 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. Methods: Patients 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. Results: After 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. Conclusions: In 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. Keywords: Polypectomy, Delayed post-polypectomy bleeding, Hemoclip, Colon polyp
* Correspondence: [email protected] 1 Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, No 5, Fu Hsing Street, Guishan Dist., Taoyuan 333, Taiwan 2 College of Medicine, Chang Gung University, Taoyuan, Taiwan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.
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