2017 Volume 59 Issue 5 Pages 1302-1309
Background/objectives : Clip plication is often performed as a conventional procedure after endoscopic resection of colorectal polyps. The postoperative bleeding rates, treatment times, and costs with or without clip plication were investigated. Methods : The subjects were 174 patients (332 lesions) undergoing clip plication after endoscopic resection between February 2012 and January 2013 (the clip group) and 210 patients (434 lesions) who did not receive clip plication with endoscopic resection performed between February 2013 and January 2014 (the non-clip group). Patient background (age, sex, underlying disease, and whether oral antithrombotic drugs were taken), characteristics of the resected polyps (number of polyps per patient, size, site, macroscopic type, and tissue), postoperative bleeding rates, and time required for polyp resection were compared between the two groups. Furthermore, the numbers of clips required for plication were studied in the clip group. Results : There were no differences in background factors or postoperative bleeding rates between the non-clip group and clip group (postoperative bleeding rate, 1.4％ vs. 1.7％), while the resection time was significantly shorter in the non-clip group than in the clip group (145 [median ; range, 46-2,443] seconds vs. 257 [91-1,789] seconds) (p<0.01). The median number of clips required for plication was 2 (1-6) and the cost per clip was JPY 1,950. Conclusion : Clip plication after resection is not necessary as a routine procedure for prevention of bleeding after endoscopic resection of colorectal polyps, and shortening of treatment time and cost reduction can be realized by its omission.
