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Clinical outcome of endoscopic management in delayed postpolypectomy bleeding
Jeong-Mi Lee1, Wan Soo Kim1, Min Seob Kwak1
1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Intestinal Research
|May 20, 2017
Summary
Endoscopic hemostasis effectively manages delayed postpolypectomy bleeding (DPPB) with a high initial success rate. Careful patient observation is advised when using multiple clips or combination therapy due to increased rebleeding risk.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Colorectal surgery
Background:
- Delayed postpolypectomy bleeding (DPPB) is a complication of colonoscopic polypectomy.
- The clinical course and risk factors for DPPB after endoscopic management require further clarification.
Purpose of the Study:
- To assess clinical outcomes following endoscopic hemostasis for DPPB.
- To identify risk factors associated with rebleeding after initial DPPB management.
Main Methods:
- Retrospective review of 198 patients who underwent endoscopic hemostasis for DPPB (January 2010 - February 2015).
- Comparison of clinical characteristics between patients with and without rebleeding.
- Multivariate analysis to determine independent risk factors for rebleeding.
Main Results:
- Initial hemostasis was achieved in all patients; 7.6% experienced rebleeding.
- Higher number of clips used and combination therapy (clipping plus other modalities) were associated with increased rebleeding risk.
- Repeat endoscopic hemostasis successfully managed all rebleeding cases.
Conclusions:
- Endoscopic hemostasis is a safe and effective treatment for DPPB, characterized by high initial success and low rebleeding rates.
- Increased clip usage and combination therapy indicate higher DPPB severity and predict a greater risk of rebleeding.
- Close monitoring of patients treated with extensive clipping or combination therapy is recommended.
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