10.1002/9781118797914

Vollständiger Abstract

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<h4>Objectives</h4>Recent changes in the perioperative management of antithrombotic therapy (ATT), including the discontinuation of routine heparin bridging and the increased use of cold snare polypectomy, may reduce delayed post-polypectomy bleeding (DPPB) rates. However, few recent studies have evaluated these changes. We compared DPPB rates between patients with and without ATT and explored factors associated with bleeding.<h4>Methods</h4>We conducted a retrospective cohort study of adult patients who underwent endoscopic resection of colorectal polyps ≤15 mm between April 2021 and October 2023. DPPB was defined as hematochezia or a hemoglobin drop ≥2.0 g/dL requiring endoscopic hemostasis. Univariable analyses were performed to identify factors associated with DPPB, and exploratory multivariable analyses were conducted.<h4>Results</h4>Among 2136 patients with 7025 polyps, 523 patients (1874 polyps) were receiving ATT. The DPPB rates per patient (1.91% vs. 0.25%) and per lesion (0.69% vs. 0.08%) were significantly higher in the ATT group (<i>p</i> < 0.001). In univariable analyses, ATT use (odds ratio [OR] 7.84), ≥3 resected lesions (OR 5.13), and hypertension (OR 3.95) were significant risk factors in the per-patient analysis, while ATT use (OR 8.73), lesion size >10 mm (OR 4.51), and clipping (OR 5.20) were significant in the per-lesion analysis. Among ATT types, warfarin users had the highest DPPB rates.<h4>Conclusions</h4>Colorectal polypectomy in patients receiving ATT is associated with an increased risk of DPPB. Particular caution is warranted in patients receiving warfarin.<h4>Trial registration</h4>N/A.

Abstract: PubMed · Datensatz