Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Colorectal Surgery

Background:

• Colorectal polyps are common, and colonoscopy with polypectomy is the standard diagnostic and therapeutic approach.
• Immediate postpolypectomy bleeding (IPPB) is a potential complication following colorectal polyp removal.
• Understanding IPPB incidence and risk factors is crucial for patient safety and procedural optimization.

Purpose of the Study:

• To determine the incidence of immediate postpolypectomy bleeding (IPPB) after colorectal polyp removal.
• To identify patient, polyp, and procedure-related risk factors associated with IPPB.

Main Methods:

• A prospective, cross-sectional study involving 5,152 patients undergoing complete colonoscopy and polypectomy at 11 tertiary medical centers.
• Evaluation of patient-related, polyp-related, and procedure-related variables.
• Univariate and multivariate logistic regression analysis to identify risk factors for IPPB (graded G1-G4).

Main Results:

• Immediate postpolypectomy bleeding (IPPB) was observed in 2.8% of colorectal polyps (215 out of 5,152 patients).
• Significant risk factors identified include older age (≥65 years), cardiovascular or chronic renal disease, anticoagulant use, polyp size >1 cm, pedunculated or laterally spreading polyp morphology, poor bowel preparation, specific electrosurgical cutting modes, and premature polyp cutting.

Conclusions:

• Nine factors are associated with an increased risk of immediate postpolypectomy bleeding.
• Polypectomy should be performed with caution in patients presenting with these identified risk factors.