RISK FACTORS OF POSTPOLYPECTOMY BLEEDING IN COLONOSCOPIC POLYPECTOMY

DOI 2 Citations 26 References
  • OKA Shigeki
    Department of Gastroenterologv & Hepatology, University Hospital rat Koshigaya, Dokkyo University School of Medicine
  • SUZUKI Kazuyoshi
    Department of Gastroenterologv & Hepatology, University Hospital rat Koshigaya, Dokkyo University School of Medicine
  • KOIZUMI Kazuhito
    Department of Gastroenterologv & Hepatology, University Hospital rat Koshigaya, Dokkyo University School of Medicine
  • ICHIMURA Hiroki
    Department of Gastroenterologv & Hepatology, University Hospital rat Koshigaya, Dokkyo University School of Medicine
  • TAKAHASHI Morio
    Department of Gastroenterologv & Hepatology, University Hospital rat Koshigaya, Dokkyo University School of Medicine

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  • 内視鏡的大腸ポリープ切除術の術後出血の危険因子に関する臨床的研究

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Abstract

BACKGROUND : The most common major complication of colonoscopic polypectomy is postpolypectomy hemorrhage. Although several factors have been implicated in the occurrence of hemorrhage, accurate prediction of delayed bleeding remains difficult. This study was undertaken in order to elucidate the risk factors of post polypectomy bleeding in routine outpatient setting. METHODS: An audit was conducted for a 3-year period of consecutive patients undergoing colonoscopic polypectomy. Patient demographics, site and size of polyps, and the use of anticoagulants and antiplatelet agents were documented from each patient's record. If the patients were taking these agents, they were suggested to discontinue for 1 week before and after polypectomy. Bleeding episodes were classified as immediate or delayed and were graded as mild, moderate, or severe. Risk factors associated with postpolypectomy bleeding were analyzed by multivariate logistic regression analysis. RESULTS : A total of 660 cases were reviewed. There were 22 cases of polypectomy-associated bleeding (3.3%) ; bleeding was immediate in 5 and delayed in 17. Multivariate analysis showed that age, the location of polyp, and the use of aspirin, non-steroidal anti-inflammatory drugs, and other antiplatelet agents were not associated with a higher risk of polypectomy-associated bleeding. CONCLUSIONS: The use of antiplatelet agents during polypectomy was not associated with an increase in post-polypectomy bleeding when they were terminated for 1 week before and after polypectomy. Multivariate analysis demonstrated that the histological degree of dysplasia was associated with a significant risk of post -polypectomy bleeding.

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