Su1496 Delayed Post-Polypectomy Bleeding Is Not Prevented by Prophylactic Hemoclips: Experience At a Tertiary Academic Medical Center

Berg, Zachary; Love, William T.; Gurudu, Suryakanth R.; Umar, Sarah B.; Leighton, Jonathan A.; Ramirez, Francisco C.

doi:10.1016/j.gie.2015.03.457

Cited by 2 publications

(4 citation statements)

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“…Significant heterogeneity was noted in this analysis (I 2 =86%, P<0.01). Based on this heterogeneity, a sensitivity analysis was performed and revealed similar results when two studies were excluded [ 15 , 23 ] with no significant heterogeneity (OR 1.24; 95% CI: 0.69-2.22; P=0.48; I 2 =35%, P=0.13).…”

Section: Resultsmentioning

confidence: 92%

“…Eight studies [ 15 - 22 ] were published in journals requiring extensive peer review while four were abstract publications [ 23 - 26 ] and were not peer-reviewed. In these peer-reviewed studies, post-polypectomy bleeding occurred in 121 polypectomies when abstracts were excluded.…”

Section: Resultsmentioning

confidence: 99%

“…The use of prophylactic clipping only after polypectomy was evaluated by 10 studies (16,483 polypectomies) [ 15 - 19 , 21 , 23 - 26 ]. Two studies were excluded from this subgroup analysis because of clipping before the polypectomy [ 20 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

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Prophylactic clipping and post-polypectomy bleeding: a metaanalysis and systematic review

Boumitri

Mir

Ashraf

et al. 2016

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BackgroundBleeding after polypectomy is a common issue associated with colonoscopy. To help prevent post-polypectomy bleeding, many endoscopists place clips at the site. However, this practice remains controversial. Therefore, we performed a meta-analysis of the efficacy of clip placement in the prevention of post-polypectomy bleeding.MethodsMultiple databases, including Embase, Scopus, MEDLINE/PubMed, CINAHL, Cochrane databases, and recent abstracts from major American meetings were searched in April 2016. Using the DerSimonian and Laird (random effects) model with odds ratio (OR), a meta-analysis was performed of post-polypectomy bleeding with prophylactic clip versus no prophylactic clip.ResultsFive hundred and thirty potential articles and abstracts were discovered. Thirty-five articles were reviewed, with 12 studies satisfying the inclusion criteria. No statistically significant difference in prophylactic clipping versus no prophylactic clipping for post-polypectomy bleeding in all polyps was found when all studies (OR 1.49; 95% CI: 0.56–4.00; P=0.42), only peer-reviewed studies where abstracts were excluded (OR 0.84; 95% CI: 0.42–1.69; P=0.63), and only randomized controlled trials (OR 1.24; 95% CI: 0.69–2.24; P=0.47) were analyzed.ConclusionsThe use of prophylactic clipping for all polypectomies does not seem to prevent post-polypectomy bleeding and should not be a routine practice. However, for large polyps (>2 cm), prophylactic clipping may or may not be beneficial in preventing post-polypectomy bleeding. Further studies are required to fully evaluate this subgroup.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

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Prophylactic clipping and post-polypectomy bleeding: a metaanalysis and systematic review

Boumitri

Mir

Ashraf

et al. 2016

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“…[3][4][5][6][7][8][9][10] Prophylactic clipping has been suggested to prevent delayed bleeding, but contradicting results have been reported. 2,[9][10][11][12] Clip closure is defined as the placement of 1 or more clips to close the mucosal defect after radical polyp resection. Because current evidence is not irrefutable, current guidelines advise against the routine use of prophylactic clipping of the resection defect, except for right-side lesions >20 mm and certain high-risk patient groups.…”

Section: Q7mentioning

confidence: 99%

The Role of Clips in Preventing Delayed Bleeding After Colorectal Polyp Resection: An Individual Patient Data Meta-Analysis

Turan¹,

Pohl

Matsumoto

et al. 2022

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS:Nonpedunculated colorectal polyps are normally endoscopically removed to prevent neoplastic progression. Delayed bleeding is the most common major adverse event. Clipping the resection defect has been suggested to reduce delayed bleedings. Our aim was to determine if prophylactic clipping reduces delayed bleedings and to analyze the contribution of polyp characteristics, extent of defect closure, and antithrombotic use. METHODS:An individual patient data meta-analysis was performed. Studies on prophylactic clipping in nonpedunculated colorectal polyps were selected from PubMed, Embase, Web of Science, and Cochrane database (last selection, April 2020). Authors were invited to share original study data. The primary outcome was delayed bleeding £30 days. Multivariable mixed models were used to determine the efficacy of prophylactic clipping in various subgroups adjusted for confounders. RESULTS:Data of 5380 patients with 8948 resected polyps were included from 3 randomized controlled trials, 2 prospective, and 8 retrospective studies. Prophylactic clipping reduced delayed bleeding in proximal polyps ‡20 mm (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.44-0.88; number needed to treat [ 32), especially with antithrombotics (OR, 0.59; 95% CI, 0.35a Members of the Prophylactic Clipping Collaborative Group:

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Su1496 Delayed Post-Polypectomy Bleeding Is Not Prevented by Prophylactic Hemoclips: Experience At a Tertiary Academic Medical Center

Cited by 2 publications

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Prophylactic clipping and post-polypectomy bleeding: a metaanalysis and systematic review

Prophylactic clipping and post-polypectomy bleeding: a metaanalysis and systematic review

The Role of Clips in Preventing Delayed Bleeding After Colorectal Polyp Resection: An Individual Patient Data Meta-Analysis

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