Multicenter randomized controlled study to assess the effect of prophylactic clipping on post-polypectomy delayed...

Area of Science:

• Gastroenterology
• Endoscopic procedures
• Surgical safety

Background:

• Prophylactic clipping is a common practice after colon polypectomy to prevent bleeding.
• Evidence supporting its routine use for all polyp sizes is lacking.
• There is no established consensus on the necessity of prophylactic clipping.

Purpose of the Study:

• To evaluate the effectiveness of prophylactic clipping in preventing post-polypectomy bleeding.
• To determine if prophylactic clipping is essential for polyps under 2 cm in diameter.

Main Methods:

• A multicenter randomized controlled trial was conducted in Japan.
• Patients with polyps <2 cm were randomized into a clipping or non-clipping group.
• Post-polypectomy bleeding rates were compared between the two groups.

Main Results:

• The study included 1499 patients and 3365 polyps.
• Bleeding rates were 1.10% in the clipping group and 0.87% in the non-clipping group.
• Non-inferiority of the non-clipping approach was demonstrated, with a 95% CI of -0.96 to 0.53.

Conclusions:

• Prophylactic clipping is not required to prevent post-polypectomy bleeding for polyps <2 cm.
• The non-clipping strategy is non-inferior to prophylactic clipping for these polyps.