Prophylactic clipping not effective in preventing post-polypectomy bleeding for < 20-mm colon polyps: A multicenter,...

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Colorectal Cancer Prevention

Background:

• Post-polypectomy bleeding (PPB) is a common complication after colon polyp removal.
• Prophylactic clipping (PC) is a technique used to reduce the risk of PPB.
• The effectiveness of PC for small (<20 mm) polyps remains unclear.

Purpose of the Study:

• To evaluate the efficacy of prophylactic clipping (PC) in preventing post-polypectomy bleeding (PPB) for colon polyps smaller than 20 mm.
• To compare PPB rates between patients who received PC and those who did not.
• To assess the impact of PC on PPB severity and post-procedural symptoms.

Main Methods:

• A multicenter, open-label, randomized controlled trial involving 1080 patients with <20 mm colon polyps.
• Patients were randomized into non-PC and PC groups.
• Primary endpoint was the difference in PPB rates; secondary endpoints included PPB severity and abdominal symptoms. Intention-to-treat and per-protocol analyses were performed.

Main Results:

• No significant difference in PPB rates between the non-PC (2.7%) and PC (2.3%) groups in intention-to-treat analysis (P=0.6973).
• Per-protocol analysis also showed no significant difference in PPB rates (3.0% vs 2.4%, P=0.7353).
• Procedure time was significantly shorter in the non-PC group, and post-procedural abdominal fullness was less common.

Conclusions:

• Prophylactic clipping is not effective in preventing post-polypectomy bleeding for colon polyps <20 mm.
• The routine use of PC for small polyps is not supported by these findings.
• Non-clipping approach may lead to shorter procedure times and fewer abdominal symptoms.