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Updated: Jun 23, 2026

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Adverse Events after Colorectal Polypectomy in Patients with Amyloidosis: Risk Assessment Using Propensity Score

Hiroshi Sawaguchi1, Tadanobu Nagaya2, Tomoyuki Nakajima3

  • 1Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.

Digestion
|June 22, 2026
PubMed
Summary

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This summary is machine-generated.

Patients with amyloidosis face a higher risk of immediate post-polypectomy bleeding (IPPB) after colorectal procedures. Muscularis mucosae deposition and endoscopic mucosal resection (EMR) are key risk factors in these patients.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Pathology

Background:

  • Amyloidosis is suspected to increase post-polypectomy bleeding risk due to fragile mucosa and vasculature.
  • This study aimed to compare adverse events following colorectal polypectomy in patients with and without amyloidosis.

Purpose of the Study:

  • To compare adverse events after colorectal polypectomy between patients with and without amyloidosis.
  • To identify risk factors for immediate post-polypectomy bleeding (IPPB) in patients undergoing colorectal polypectomy.

Main Methods:

  • Retrospective analysis of 21 amyloidosis patients and 110 non-amyloidosis patients undergoing cold snare polypectomy (CSP) or endoscopic mucosal resection (EMR).
  • Propensity score matching was used to compare IPPB, delayed bleeding, and perforation rates.
Keywords:
AmyloidosisImmediate post-polypectomy bleedingPolypectomy

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  • Generalized estimating equation (GEE) logistic regression analyzed risk factors for IPPB in the matched cohort.
  • Main Results:

    • Immediate post-polypectomy bleeding (IPPB) occurred significantly more often in the amyloidosis group (p = 0.008).
    • Amyloidosis was independently associated with increased IPPB risk (adjusted OR 3.20, p = 0.027).
    • In amyloidosis patients, muscularis mucosae deposition (OR 6.55, p = 0.009) and EMR (OR 8.26, p = 0.020) predicted IPPB.

    Conclusions:

    • Amyloidosis is an independent risk factor for increased IPPB after colorectal polypectomy.
    • Muscularis mucosae deposition and EMR identify higher-risk lesions in amyloidosis patients.
    • Consider cold snare polypectomy (CSP) when feasible to mitigate bleeding risk in amyloidosis patients.