Postpolypectomy bleeding of colorectal polyps in patients with continuous warfarin and short-term interruption of direct oral anticoagulants
This study aimed to evaluate PPB in patients receiving treatment with warfarin and direct oral anticoagulants (DOACs).
Conclusions Prophylactic HC placement is effective in prevention of DPPB from proximal colon polyps ≥ 2 cm, but of no significant benefit for polyps 1 to 1.9 cm in size or for distal colon polyps ≥ 2 cm. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | open access Full text
Conclusions In an organized screening program, post-colonoscopy adverse events were rare but not negligible. The most frequent event was post-polypectomy bleeding, especially after resection of large (≥ 20 mm) and proximal lesions. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents | Abstract | Full text
Conclusion Ongoing or recurrent hematochezia is associated with a high rate of hemostatic therapy, warranting re-colonoscopy in these patients. A conservative approach is justified when bleeding spontaneously settles, and without recurrent hematochezia during 24 hours observation patients can be safely discharged without endoscopic re-examination. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | open access Full text
Authors: Yang YJ Abstract Capsule endoscopy has revolutionized the management of small-bowel diseases owing to its convenience and noninvasiveness. Capsule endoscopy is a common method for the evaluation of obscure gastrointestinal bleeding, Crohn's disease, small-bowel tumors, and polyposis syndrome. However, the laborious reading process, oversight of small-bowel lesions, and lack of locomotion are major obstacles to expanding its application. Along with recent advances in artificial intelligence, several studies have reported the promising performance of convolutional neural network systems for the diagnosis of ...
ConclusionThe results of this pilot study suggest a potential role of local spray application of Glubran ®2 in reducing post-procedural bleeding.
Authors: Tang MH, Foo FJ, Ng CY Abstract Background/Aims: Sigmoidoscopy is performed in most medical centers to evaluate the distal colons of young adults presenting with hematochezia who are at risk of developing proximal lesions. Colonoscopies offer more complete evaluations but are associated with a higher incidence of complications and possible low yield. Methods: An analysis was conducted on colonoscopies performed in our center on patients 40 years of age or younger. The study population was sub-divided into 2 age groups for analysis:
Colonoscopic removal of adenomatous polyps has a preventive effect for colorectal cancer. Cold snare polypectomy is an effective method of polyp removal for small polyps (5 mm to 10 mm). Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) is used for larger polyps (>10 mm). Submucosal injection during EMR or ESD is helpful to prevent complications. However, the effect of submucosal injection in cold snare polypectomy for small polyps is not clear. The aim of this study is to evaluate the risks of bleeding in cold snare polypectomy for small polyps and to investigate the effect of submucosal injection.
Postpolypectomy bleeding and incomplete polyp removal are important complication and quality concerns of colonoscopy for colon cancer prevention. Endoscopic mucosal stripping (EMS) is a modified extension of traditional cold snare polypectomy to avoid submucosal injury during removal of non-pedunculated colon polyps. We previously demonstrated EMS could potentially eliminate postpolypectomy bleeding, especially for advanced colon polyps, and facilitate complete polyp removal based on polypectomy site biopsy and short-term follow-up colonoscopy (1,2).
Prophylactic clipping can decrease delayed post-polypectomy bleeding (DPPB) in large polyps (20mm) resected with endoscopic mucosal resection (EMR). However, despite the absence of strong evidence demonstrating clinical benefit, endoscopists usually place clips after large polypectomies. For example, multiple studies have shown differing results of clipping versus no clipping to prevent DPPB. Moreover, previous meta-analyses have also generated conflicting conclusions regarding the clinical benefit of clipping to reduce DPPB.
This study evaluated the risk of delayed bleeding after restarting DOACs within 24 hours after endoscopic resection of large colorectal polyps.