Practice patterns and predictors of prophylactic endoscopic clip usage during polypectomy

Endosc Int Open 2019; 07: E1051-E1060 DOI: 10.1055/a-0953-1787 Background and study aims Prophylactic endoscopic clips are commonly placed during polypectomy to reduce risk of delayed bleeding, although evidence to support this practice is unclear. Our study aimed to: (1) identify variables associated with prophylactic clip use; (2) explore variability between endoscopists’ clipping practices and (3) study temporal trends in prophylactic clip use. Patients and methods This was a retrospective cohort study in a high-volume unit dedicated to screening-related colonoscopies. Colonoscopies involving polypectomy from 2008 to 2014 were reviewed. The primary outcome was prophylactic clipping status, both at the patient level and per polyp. Hierarchical regression models yielded adjusted odds ratios (AORs) to determine predictors of prophylactic clipping. Results A total of 8,366 colonoscopies involving 19,129 polypectomies were included. Polyp size ≥ 20 mm was associated with higher clip usage (AOR 2.94; 95 % CI: 2.43, 3.54) compared to polyps
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research

Related Links:

The sequence of events leading to the development of colorectal cancer, currently the third most common malignancy in Western countries, is effectively disrupted by the resection of its precursor lesions. Colonoscopy is the mainstay in lesion detection, and endoscopic polypectomy is the conventional therapeutic response for the overwhelming majority of identified polyps. Approximately 2% of lesions are larger (>20  mm) and are laterally spreading lesions (LSLs). EMR is considered the standard of care for the majority of these because it has been proved to be safer, less resource-intensive, and less expensive than surgery.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
ConclusionsA focused training intervention was associated with a strong trend toward increased ADRs among certified endoscopists. While the described training interventions definitely show promise, further efforts around continuing professional developments activities are needed to more consistently improve ADRS among certified endoscopists.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Authors: Miwa T, Ibuka T, Ozawa N, Sugiyama T, Kubota M, Imai K, Sakai H, Takai K, Araki H, Shimizu M Abstract Colonic varices are usually associated with portal hypertension. Idiopathic colonic varices are extremely rare. A 68-year-old man with a positive fecal occult blood test result underwent colonoscopy. We detected idiopathic ileocolonic varices and a coexisting ascending colon polyp. While reviewing the literature, we found cases of biopsies and polypectomies resulting in significant bleeding. We herein report a case of idiopathic ileocolonic varices coexisting with a colon polyp treated successfully by endo...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Lee YJ, Park JH Abstract PMID: 31121995 [PubMed - as supplied by publisher]
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
Conclusion: s: Single left-sided juvenile polyps were the most common cause of isolated lower gastrointestinal bleeding in our study. It was rare to find multiple polyps and polyps proximal to the splenic flexure in our cohort. A full colonoscopy is still recommended in all patients in order to properly diagnose the small but significant group of patients with pathologies found proximal to the splenic flexure. PMID: 31085966 [PubMed - as supplied by publisher]
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
CONCLUSION: Also in our experience adenomatous polyps play a crucial role in the development of colorectal cancer. Therefore, it seems quite essential to avert colorectal cancers gradually. Colonoscopy is a non-invasive method of diagnosis and a treatment of colorectal polyps. Proper and careful colonoscopy examination is indispensable in the discovery of colorectal polyps and subsequent follow-up. Timely and routine colonoscopy is considered as an important approach for thwarting the development of malignant neoplasms. KEY WORDS: Adenomatous polyps, Colorectal cancer, Colorectal polyps, Post-polypectomy. PMID: 309...
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
This study retrospectively analyzed a prospectively maintained screening colonoscopy database in a university hospital in Taiwan. We compared the rate of delayed bleeding before and after implementation within similar periods (18 months and 15 months) and the respective number of polypectomies (1,304 and 1,255) performed to remove small and diminutive polyps. The main outcome measurement was delayed bleeding within the two periods. Multivariate analysis was performed to adjust for major confounders. Results A total of 1,304 and 1,225 subjects received hot snare polypectomy (HSP) and CSP in two separate periods, res...
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Publication date: Available online 19 November 2018Source: The LancetAuthor(s): Mark A Hull, Kirsty Sprange, Trish Hepburn, Wei Tan, Aisha Shafayat, Colin J Rees, Gayle Clifford, Richard F Logan, Paul M Loadman, Elizabeth A Williams, Diane Whitham, Alan A Montgomery, seAFOod Collaborative GroupSummaryBackgroundThe omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) and aspirin both have proof of concept for colorectal cancer chemoprevention, aligned with an excellent safety profile. Therefore, we aimed to test the efficacy of EPA and aspirin, alone and in combination and compared with a placebo, in individuals w...
Source: The Lancet - Category: General Medicine Source Type: research
CONCLUSION: The colonoscopy service at CCH was safe and complied with the accepted quality indicators. Our data suggest that delivery of high-quality colonoscopy services might be possible in similar peripheral and day hospitals around New Zealand. Increasing colonoscopy services in such centres would reduce the excessive workload of larger public hospitals and reduce the level of unmet need for colonoscopy services. PMID: 30359353 [PubMed - in process]
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
Abstract The occurrence of heterotopic tissue in the large intestine is unusual. The most common heterotopic tissue type described is gastric-type mucosa. On the other hand, heterotopic salivary gland tissue in the large intestine is extremely rare. To the best of the authors' knowledge, only five cases of heterotopic salivary gland in the large intestine have been reported, and all cases arose in the left colon. One out of five cases arose in the sigmoid colon, and the four other cases were found in the rectum-anal canal region. Endoscopically, they usually appeared as a polyp. The presentation of the patients wa...
Source: Korean J Gastroenter... - Category: Gastroenterology Authors: Tags: Korean J Gastroenterol Source Type: research
More News: Bleeding | Colonoscopy | Education | Endoscopy | Gastroenterology | Polyps | Study