Endoscopic characteristics influencing postpolypectomy bleeding in 1147 consecutive pedunculated colonic polyps: a...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Postpolypectomy bleeding is a common complication, particularly with pedunculated polyps.
• Identifying endoscopic characteristics that influence bleeding is crucial for patient safety.

Purpose of the Study:

• To clarify endoscopic factors associated with postpolypectomy bleeding in pedunculated colonic polyps.
• To inform strategies for reducing bleeding complications during colon polyp removal.

Main Methods:

• Retrospective review of 1147 pedunculated colonic polyp resections across 5 Japanese institutions.
• Analysis of clinical data including polyp characteristics, prophylactic measures, and bleeding events (immediate and delayed).

Main Results:

• Stalk width ≥6 mm was a significant risk factor for immediate bleeding (OR 1.9).
• Prophylactic endoloop use inhibited immediate bleeding for polyps ≥15 mm (OR 0.17).
• Prophylactic clipping (OR 4.2) and stalk injection (OR 4.0) increased delayed bleeding risk.

Conclusions:

• Simple resection with coagulation mode is suggested for pedunculated polyps to minimize delayed bleeding.
• Prophylactic endoloop use is effective in preventing immediate bleeding for larger polyps (≥15 mm).