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Comparison of clipping with and without epinephrine injection for the prevention of post-polypectomy bleeding in pedunculated colon polyps

 Yehyun Park  ;  Tae Joo Jeon  ;  Ji Young Park  ;  Soo Jung Park  ;  Jae Hee Cheon  ;  Tae Il Kim  ;  Won Ho Kim  ;  Sung Pil Hong 
 Journal of Gastroenterology and Hepatology, Vol.30(10) : 1499-1506, 2015 
Journal Title
 Journal of Gastroenterology and Hepatology 
Issue Date
BACKGROUND AND AIM: Post-polypectomy bleeding (PPB) is the most common adverse event of colonoscopic polypectomy, especially in cases with large pedunculated polyps. To minimize the risk of PPB, several endoscopic preventive methods have been performed. The aim of this prospective, randomized study was to compare the rates of PPB following single (clipping alone) and combined (clipping plus epinephrine-saline injection) methods in prevention of PPB in large pedunculated polyps. METHODS: Adult patients with pedunculated colorectal polyps with heads ≥ 10 mm were prospectively enrolled from March 2011 to January 2013. Patients were randomized to receive treatment of either clips alone (group A) or clips plus injection of epinephrine-saline (group B) prior to a conventional polypectomy. PPB rate in both groups were compared. RESULTS: A total of 148 patients with 173 pedunculated colorectal polyps were enrolled. Groups A and B each had 74 patients, with 83 and 90 polyps, respectively. The mean head diameters were 17.2 ± 6.6 and 17.5 ± 6.7 mm in groups A and B, respectively (P = 0.748). Immediate PPB (IPPB) occurred in 10 cases (12.0%) from group A and 13 cases (14.4%) from group B (P = 0.64). There were no cases of delayed PPB or perforation. Multivariate analysis showed that inadequate bowel preparation and large head diameter of polyp were independent risk factors for IPPB. CONCLUSIONS: The rate of IPPB is relatively high in cases with large pedunculated polyps, but these polyps can be successfully resected by snare polypectomy following use of the single prophylactic clipping method.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김원호(Kim, Won Ho)
김태일(Kim, Tae Il) ORCID logo https://orcid.org/0000-0003-4807-890X
박수정(Park, Soo Jung)
박예현(Park, Yehyun) ORCID logo https://orcid.org/0000-0001-8811-0631
천재희(Cheon, Jae Hee) ORCID logo https://orcid.org/0000-0002-2282-8904
홍성필(Hong, Sung Pil)
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