Takaaki Kishino1, Tsuneo Oyama2, Kinichi Hotta3, Eiji Ishii4, Tamaki Momoi5, Takehiro Shimizu6, Kenji Kunieda7, Shinichiro Takeda8, Hirokazu Komatsu9. 1. Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan; Department of Gastroenterology, Nara City Hospital, Nara, Japan. 2. Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan. 3. Division of Endoscopy and Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi, Japan. 4. Nakamura Clinic, Shimanto, Japan. 5. Department of Gastroenterology, Saku Central Hospital Advanced Care Center, Saku, Japan. 6. Department of Gastroenterology, Isesaki Municipal Hospital, Isesaki, Japan. 7. Department of Medical Oncology, Saku Central Hospital Advanced Care Center, Saku, Japan. 8. Department of Gastroenterology, Matsudo City Hospital, Matsudo, Japan. 9. Department of Community Care, Saku Central Hospital, Saku, Japan.
Abstract
BACKGROUND/AIMS: Few studies have examined the incidence of post-polypectomy bleeding (PPB) after discontinuation of antithrombotic therapies. Therefore, this study aimed to evaluate the incidence of PPB and thromboembolic events in patients whose antithrombotic agents were discontinued before colonoscopy. MATERIALS AND METHODS: We retrospectively selected all patients who underwent colon polypectomy at a community hospital. A total of 282 patients (540 polypectomies) discontinued antithrombotic agents (group 1), and 1,648 patients (2,827 polypectomies) did not take antithrombotic agents (group 2). The cessation periods before and after polypectomies were 4 and 3 days for warfarin, 5 and 3 days for anti-platelet agents, and 7 and 5 days of combination therapy, respectively. Main outcome measurements were the incidence of PPB and thromboembolic events. RESULTS: Immediate PPB rates were 3.9% (11/282) in group 1 and 4.6% (76/1648) in group 2 (adjusted odds ratio [OR], 0.85; 95% confidence interval [CI], 0.42-1.72; p=0.65). Delayed PPB rates were 1.4% (4/282) in group 1 and 1.1% (18/1648) in group 2 (adjusted OR, 1.24; 95% CI, 0.36-4.24; p=0.732). No thromboembolic events were observed in either group. CONCLUSION: Our cessation periods were appropriate, and further shortening of these periods is possible.
BACKGROUND/AIMS: Few studies have examined the incidence of post-polypectomy bleeding (PPB) after discontinuation of antithrombotic therapies. Therefore, this study aimed to evaluate the incidence of PPB and thromboembolic events in patients whose antithrombotic agents were discontinued before colonoscopy. MATERIALS AND METHODS: We retrospectively selected all patients who underwent colon polypectomy at a community hospital. A total of 282 patients (540 polypectomies) discontinued antithrombotic agents (group 1), and 1,648 patients (2,827 polypectomies) did not take antithrombotic agents (group 2). The cessation periods before and after polypectomies were 4 and 3 days for warfarin, 5 and 3 days for anti-platelet agents, and 7 and 5 days of combination therapy, respectively. Main outcome measurements were the incidence of PPB and thromboembolic events. RESULTS: Immediate PPB rates were 3.9% (11/282) in group 1 and 4.6% (76/1648) in group 2 (adjusted odds ratio [OR], 0.85; 95% confidence interval [CI], 0.42-1.72; p=0.65). Delayed PPB rates were 1.4% (4/282) in group 1 and 1.1% (18/1648) in group 2 (adjusted OR, 1.24; 95% CI, 0.36-4.24; p=0.732). No thromboembolic events were observed in either group. CONCLUSION: Our cessation periods were appropriate, and further shortening of these periods is possible.
Authors: Deborah A Fisher; John T Maple; Tamir Ben-Menachem; Brooks D Cash; G Anton Decker; Dayna S Early; John A Evans; Robert D Fanelli; Norio Fukami; Joo Ha Hwang; Rajeev Jain; Terry L Jue; Khalid M Khan; Phyllis M Malpas; Ravi N Sharaf; Amandeep K Shergill; Jason A Dominitz Journal: Gastrointest Endosc Date: 2011-10 Impact factor: 9.427
Authors: Cynthia W Ko; Stacy Riffle; Leann Michaels; Cynthia Morris; Jennifer Holub; Jean A Shapiro; Marcia A Ciol; Michael B Kimmey; Laura C Seeff; David Lieberman Journal: Clin Gastroenterol Hepatol Date: 2009-10-20 Impact factor: 11.382
Authors: G Palareti; C Legnani; G Guazzaloca; M Frascaro; F Grauso; F De Rosa; G Fortunato; S Coccheri Journal: Thromb Haemost Date: 1994-08 Impact factor: 5.249