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Prospective analysis of delayed colorectal post-polypectomy bleeding

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Abstract

Backgrounds/aims

Although post-polypectomy bleeding is the most frequent complication after colonoscopic polypectomy, only few studies have investigated the incidence of bleeding prospectively. The aim of this study was to investigate the incidence of delayed post-polypectomy bleeding and its associated risk factors prospectively.

Methods

Patients who underwent colonoscopic polypectomy at Kangbuk Samsung Hospital from January 2013 to December 2014 were prospectively enrolled in this study. Trained nurses contacted patients via telephone 7 and 30 days after polypectomy and completed a standardized questionnaire regarding the development of bleeding. Delayed post-polypectomy bleeding was categorized as minor or major and early or late bleeding. Major delayed bleeding was defined as a > 2-g/dL drop in the hemoglobin level, requiring hospitalization for control of bleeding or blood transfusion; late delayed bleeding was defined as bleeding occurring later than 24 h after polypectomy.

Results

A total of 8175 colonoscopic polypectomies were performed in 3887 patients. Overall, 133 (3.4%) patients developed delayed post-polypectomy bleeding. Among them, 90 (2.3%) and 43 (1.1%) patients developed minor and major delayed bleeding, respectively, and 39 (1.0%) patients developed late delayed bleeding. In the polyp-based multivariate analysis, young age (< 50 years; odds ratio [OR] 2.10; 95% confidence interval [CI] 1.18–3.68), aspirin use (OR 2.78; 95% CI 1.23–6.31), and polyp size of > 10 mm (OR 2.45; 95% CI 1.38–4.36) were significant risk factors for major delayed bleeding, while young age (< 50 years; OR 2.6; 95% CI 1.35–5.12) and immediate bleeding (OR 3.3; 95% CI 1.49–7.30) were significant risk factors for late delayed bleeding.

Conclusions

Young age, aspirin use, polyp size, and immediate bleeding were found to be independent risk factors for delayed post-polypectomy bleeding.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, South Korea

    Soo-Kyung Park, Jeong Yeon Seo, Min-Gu Lee, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi & Dong Il Park

  2. Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, South Korea

    Hungdai Kim, Hyung Ook Kim, Kyung Uk Jung & Ho-Kyung Chun

  3. Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, South Korea

    Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jung, Ho-Kyung Chun & Dong Il Park

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  1. Soo-Kyung Park
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Correspondence to Dong Il Park.

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Disclosure

Drs. Soo-Kyung Park, Jeong Yeon Seo, Min-Gu Lee, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jeong, Ho-Kyung Chun, and Dong Il Park have no conflicts of interest or financial ties to disclose.

Additional information

Soo-Kyung Park and Jeong Yeon Seo are co-first authors.

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Park, SK., Seo, J.Y., Lee, MG. et al. Prospective analysis of delayed colorectal post-polypectomy bleeding. Surg Endosc 32, 3282–3289 (2018). https://doi.org/10.1007/s00464-018-6048-9

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  • DOI: https://doi.org/10.1007/s00464-018-6048-9

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