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• W2004559968 abstract "BackgroundAlthough endoscopic colonic polypectomy has been an established procedure for two decades, the risk of bleeding is still higher after resecting of pedunculated polyps, because of the presence of a large artery in the stalk. Several preventive methods such as detachable snare and adrenaline injection have been proposed in the management of postpolypectomy bleeding in large colonic polyps. For prophylactic clip, there was no prospective randomized study assessing the efficacy in the prevention of postpolypectomy bleeding for the large pedunculated polyps. So we designed a prospective, randomized study to compares the efficacy of application of prophylactic clip and detachable snare in the prevention of postpolypectomy bleeding in large polyps.MethodsPatients with pedunculated colorectal polyps, the heads of which were larger than 10mm and the stalk of which were large than 5 mm in diameter, were included. Before conventional snare polypectomy, hemoclips were applied on the base of stalk in the prophylactic clip group (36 patients). In the detachable snare group, detachable snare was positioned at the base of stalk and followed by conventional snare polypectomy (35 patients). Immediate (bleeding occurring immediately after polypectomy and lasting for 30 s or more) and delayed bleeding complications were assessed. Delayed bleeding was subdivide into early (<24 h) and late (>24 h-30 days).ResultsThe mean size of polyp head was 18.5 ± 1.9 mm and 23.3 ± 2.6 mm, respectively, for the prophylactic clip and detachable snare group (p=0.139). In prophylactic group, the mean size of stalk width was 7.8 ± 2.0 mm and in detachable snare group it was 8.9 ± 2.5 mm (p=0.345). One case of immediate bleeding was observed in the both groups. Both cases of bleeding were successfully controlled with placement of additional hemoclips. There was only one case of late (31 h) bleeding in the prophylactic clip group (2.8%). On the follow-up colonoscopy only blood clot was observed and no blood transfusion was required. Histopathology of the polyp showed hamartoma. In detachable snare group, delayed bleeding case was not observed (0%).ConclusionsOut data showed that the application of prophylactic clip is as effective and safe method as detachable snare in the prevention of postpolypectomy bleeding for the large pedunculated colonic polyps. BackgroundAlthough endoscopic colonic polypectomy has been an established procedure for two decades, the risk of bleeding is still higher after resecting of pedunculated polyps, because of the presence of a large artery in the stalk. Several preventive methods such as detachable snare and adrenaline injection have been proposed in the management of postpolypectomy bleeding in large colonic polyps. For prophylactic clip, there was no prospective randomized study assessing the efficacy in the prevention of postpolypectomy bleeding for the large pedunculated polyps. So we designed a prospective, randomized study to compares the efficacy of application of prophylactic clip and detachable snare in the prevention of postpolypectomy bleeding in large polyps. Although endoscopic colonic polypectomy has been an established procedure for two decades, the risk of bleeding is still higher after resecting of pedunculated polyps, because of the presence of a large artery in the stalk. Several preventive methods such as detachable snare and adrenaline injection have been proposed in the management of postpolypectomy bleeding in large colonic polyps. For prophylactic clip, there was no prospective randomized study assessing the efficacy in the prevention of postpolypectomy bleeding for the large pedunculated polyps. So we designed a prospective, randomized study to compares the efficacy of application of prophylactic clip and detachable snare in the prevention of postpolypectomy bleeding in large polyps. MethodsPatients with pedunculated colorectal polyps, the heads of which were larger than 10mm and the stalk of which were large than 5 mm in diameter, were included. Before conventional snare polypectomy, hemoclips were applied on the base of stalk in the prophylactic clip group (36 patients). In the detachable snare group, detachable snare was positioned at the base of stalk and followed by conventional snare polypectomy (35 patients). Immediate (bleeding occurring immediately after polypectomy and lasting for 30 s or more) and delayed bleeding complications were assessed. Delayed bleeding was subdivide into early (<24 h) and late (>24 h-30 days). Patients with pedunculated colorectal polyps, the heads of which were larger than 10mm and the stalk of which were large than 5 mm in diameter, were included. Before conventional snare polypectomy, hemoclips were applied on the base of stalk in the prophylactic clip group (36 patients). In the detachable snare group, detachable snare was positioned at the base of stalk and followed by conventional snare polypectomy (35 patients). Immediate (bleeding occurring immediately after polypectomy and lasting for 30 s or more) and delayed bleeding complications were assessed. Delayed bleeding was subdivide into early (<24 h) and late (>24 h-30 days). ResultsThe mean size of polyp head was 18.5 ± 1.9 mm and 23.3 ± 2.6 mm, respectively, for the prophylactic clip and detachable snare group (p=0.139). In prophylactic group, the mean size of stalk width was 7.8 ± 2.0 mm and in detachable snare group it was 8.9 ± 2.5 mm (p=0.345). One case of immediate bleeding was observed in the both groups. Both cases of bleeding were successfully controlled with placement of additional hemoclips. There was only one case of late (31 h) bleeding in the prophylactic clip group (2.8%). On the follow-up colonoscopy only blood clot was observed and no blood transfusion was required. Histopathology of the polyp showed hamartoma. In detachable snare group, delayed bleeding case was not observed (0%). The mean size of polyp head was 18.5 ± 1.9 mm and 23.3 ± 2.6 mm, respectively, for the prophylactic clip and detachable snare group (p=0.139). In prophylactic group, the mean size of stalk width was 7.8 ± 2.0 mm and in detachable snare group it was 8.9 ± 2.5 mm (p=0.345). One case of immediate bleeding was observed in the both groups. Both cases of bleeding were successfully controlled with placement of additional hemoclips. There was only one case of late (31 h) bleeding in the prophylactic clip group (2.8%). On the follow-up colonoscopy only blood clot was observed and no blood transfusion was required. Histopathology of the polyp showed hamartoma. In detachable snare group, delayed bleeding case was not observed (0%). ConclusionsOut data showed that the application of prophylactic clip is as effective and safe method as detachable snare in the prevention of postpolypectomy bleeding for the large pedunculated colonic polyps. Out data showed that the application of prophylactic clip is as effective and safe method as detachable snare in the prevention of postpolypectomy bleeding for the large pedunculated colonic polyps." @default.
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• W2004559968 title "525 Comparison of Prophylactic Clip and Detachable Snare for the Prevention of Postpolypectomy Bleeding for the Large Pedunculated Colonic Polyps: A Prospective, Randomized Study" @default.
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