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Colorectal Post-polypectomy Bleeding in Outpatient versus Inpatient Treatment: Propensity Score Matching Analysis.

Takato Maeda1,2, Hirotake Sakuraba2, Takao Oyama1

  • 1Department of Gastroenterology, Tsugaru General Hospital, Aomori, Japan.

Journal of the Anus, Rectum and Colon
|August 1, 2024
PubMed
Summary

Outpatient endoscopic mucosal resection (EMR) and hot snare polypectomy (HSP) for colorectal polyps are safe. Delayed bleeding rates were similar between outpatient and inpatient treatments, supporting the common use of outpatient procedures.

Keywords:
colorectal polypdelayed bleedingendoscopic mucosal resectionhot snare polypectomyinpatientoutpatient

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Colorectal Surgery

Background:

  • Delayed bleeding is a frequent complication of colorectal polyp removal via endoscopic mucosal resection (EMR) and hot snare polypectomy (HSP).
  • The comparative safety of outpatient versus inpatient endoscopic treatment for colorectal polyps regarding delayed bleeding remains unclear.

Purpose of the Study:

  • To evaluate and compare the incidence of delayed bleeding between outpatient and inpatient endoscopic treatments for colorectal polyps.
  • To determine the safety and feasibility of outpatient endoscopic polyp removal.

Main Methods:

  • A retrospective study involving 469 patients (outpatient) and 420 patients (inpatient) undergoing EMR or HSP for colorectal polyps.
  • Propensity score matching was used to create comparable groups for analysis of delayed bleeding rates within 14 days post-procedure.

Main Results:

  • After propensity score matching, 376 patient pairs were analyzed. Delayed bleeding rates per patient were 1.3% (outpatient) and 2.9% (inpatient) (P=0.21).
  • Early delayed bleeding (within 24 hours) occurred at a higher rate per polyp in the inpatient group (1.1%) compared to the outpatient group (0.2%) (P=0.04).
  • No severe bleeding requiring transfusion was observed in either group.

Conclusions:

  • Outpatient endoscopic treatment for colorectal polyps is associated with comparable delayed bleeding rates to inpatient treatment.
  • Outpatient endoscopic procedures for colorectal polyp removal are safe and can be widely adopted.