Complete closure utilizing titanium clips minimizes delayed postpolypectomy bleeding after colorectal endoscopic...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Delayed postpolypectomy bleeding (DPPB) is a common complication after endoscopic mucosal resection (EMR) of colonic polyps.
• Prophylactic clip closure is recommended for polyps >20mm in the right colon, but its efficacy for smaller polyps is debated.
• No studies have evaluated the impact of complete clip closure on DPPB for colorectal polyps ≤20mm.

Purpose of the Study:

• To determine if complete clip closure prevents delayed postoperative bleeding after EMR for colorectal polyps ≤20mm.
• To identify patient, polyp, and procedure-related factors influencing DPPB.

Main Methods:

• Retrospective study of 1259 colorectal polyps from 1025 patients undergoing EMR (January 2020 - October 2024).
• Univariate and logistic regression analyses were used to assess risk factors for DPPB.
• Factors analyzed included patient demographics, polyp characteristics, and closure technique (complete vs. partial).

Main Results:

• The incidence of DPPB was 3.6% (37 of 1259 polyps).
• Logistic regression identified male gender (OR 3.870), large polyp size (OR 1.158), and partial clip closure (OR 5.447) as significant risk factors for DPPB.
• Partial closure was strongly associated with an increased risk of DPPB.

Conclusions:

• Male gender, larger polyp size, and partial closure are significant risk factors for DPPB.
• Complete closure of the EMR site is crucial for minimizing the risk of delayed bleeding.
• Ensuring complete closure is an actionable strategy to reduce DPPB incidence.