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Risk factors for delayed post-polypectomy bleeding.

Min Jung Kwon¹, You Sun Kim¹, Song I Bae¹

¹Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Intestinal Research

|May 2, 2015

Summary

Delayed post-polypectomy bleeding (PPB) after colonoscopy is a serious complication. Risk factors include large or pedunculated polyps, right-sided location, and high BMI, necessitating increased caution during procedures.

Keywords:

Colonoscopy Complication Hemorrhage Polypectomy

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Area of Science:

Gastroenterology
Endoscopy
Surgical Complications

Background:

Delayed post-polypectomy bleeding (PPB) is a significant complication following colonoscopic polypectomy, occurring in 1.0-6.1% of procedures.
Identifying risk factors for PPB is crucial for improving patient safety during therapeutic endoscopy.

Purpose of the Study:

To identify and analyze the risk factors associated with delayed post-polypectomy bleeding (PPB) after colonoscopic polypectomy.

Main Methods:

A retrospective review of 1,745 patients undergoing colonoscopic polypectomy between January 2003 and December 2012.
Comparison of patients with delayed PPB (n=21) against age- and sex-matched controls (3:1 ratio).
Analysis of clinical data including polyp characteristics (size, number, location, shape), patient BMI, preventive hemostasis, and endoscopist experience.

Main Results:

Delayed PPB occurred in 1.2% of patients.
Significant risk factors for delayed PPB included polyps >10 mm (OR, 2.605), pedunculated polyps (OR, 3.517), polyps in the right hemicolon (OR, 3.10), and high BMI (OR, 3.681).

Conclusions:

Delayed PPB is a rare but serious complication of colonoscopic polypectomy.
Increased vigilance is recommended for patients with high BMI, large polyps, pedunculated polyps, or polyps located in the right hemicolon.