OBJECTIVES: Delayed hemorrhage is an infrequent, but serious complication of colonoscopic polypectomy. Large size is the only polyp-related factor that has been unequivocally proven to increase the risk of delayed bleeding. It has been suggested that location in the right hemi-colon is also a risk factor. The objective of this study was to determine whether polyp location is an independent risk factor for delayed post-polypectomy hemorrhage. METHODS: A retrospective case-control study was conducted in two university hospitals and two community hospitals. RESULTS: Thirty-nine cases and 117 controls were identified. In multivariate analysis, size and location were found to be independent polyp-related risk factors for delayed type hemorrhage. The risk increased by 13% for every 1 mm increase in polyp diameter (odds ratio (OR) 1.13, 95% confidence interval (CI) 1.05-1.20, P<0.001). Polyps located in the right hemi-colon had an OR of 4.67 (1.88-11.61, P=0.001) for delayed hemorrhage. Polyps in the cecum seemed to be especially at high risk in univariate analysis (OR 13.82, 95% CI 2.66-71.73), but this could not be assessed in multivariate analysis as the number of cases was too small. Polyp type (sessile or pedunculated) was not a risk factor. CONCLUSIONS: Polyp location in the right hemi-colon seems to be an independent and substantial risk factor for delayed post-polypectomy hemorrhage. A low threshold for preventive hemostatic measures is advised when removing polyps from this region.
OBJECTIVES: Delayed hemorrhage is an infrequent, but serious complication of colonoscopic polypectomy. Large size is the only polyp-related factor that has been unequivocally proven to increase the risk of delayed bleeding. It has been suggested that location in the right hemi-colon is also a risk factor. The objective of this study was to determine whether polyp location is an independent risk factor for delayed post-polypectomy hemorrhage. METHODS: A retrospective case-control study was conducted in two university hospitals and two community hospitals. RESULTS: Thirty-nine cases and 117 controls were identified. In multivariate analysis, size and location were found to be independent polyp-related risk factors for delayed type hemorrhage. The risk increased by 13% for every 1 mm increase in polyp diameter (odds ratio (OR) 1.13, 95% confidence interval (CI) 1.05-1.20, P<0.001). Polyps located in the right hemi-colon had an OR of 4.67 (1.88-11.61, P=0.001) for delayed hemorrhage. Polyps in the cecum seemed to be especially at high risk in univariate analysis (OR 13.82, 95% CI 2.66-71.73), but this could not be assessed in multivariate analysis as the number of cases was too small. Polyp type (sessile or pedunculated) was not a risk factor. CONCLUSIONS: Polyp location in the right hemi-colon seems to be an independent and substantial risk factor for delayed post-polypectomy hemorrhage. A low threshold for preventive hemostatic measures is advised when removing polyps from this region.
Authors: R Manta; F Tremolaterra; A Arezzo; M Verra; G Galloro; L Dioscoridi; F Pugliese; A Zullo; M Mutignani; G Bassotti Journal: Tech Coloproctol Date: 2015-07-11 Impact factor: 3.781
Authors: Heiko Pohl; Ian S Grimm; Matthew T Moyer; Muhammad K Hasan; Douglas Pleskow; B Joseph Elmunzer; Mouen A Khashab; Omid Sanaei; Firas H Al-Kawas; Stuart R Gordon; Abraham Mathew; John M Levenick; Harry R Aslanian; Fadi Antaki; Daniel von Renteln; Seth D Crockett; Amit Rastogi; Jeffrey A Gill; Ryan J Law; Pooja A Elias; Maria Pellise; Michael B Wallace; Todd A Mackenzie; Douglas K Rex Journal: Gastroenterology Date: 2019-03-15 Impact factor: 22.682
Authors: Matthew D Rutter; Amit Chattree; Jamie A Barbour; Siwan Thomas-Gibson; Pradeep Bhandari; Brian P Saunders; Andrew M Veitch; John Anderson; Bjorn J Rembacken; Maurice B Loughrey; Rupert Pullan; William V Garrett; Gethin Lewis; Sunil Dolwani Journal: Gut Date: 2015-06-23 Impact factor: 23.059
Authors: Xian-rui Wu; James M Church; Awad Jarrar; Jennifer Liang; Matthew F Kalady Journal: Int J Colorectal Dis Date: 2013-02-26 Impact factor: 2.571