Abstract
Background : The most common complication with colonoscopic polypectomy is hemor rhage that occurs within 24 hours after polyp removal. We often use clips to stop or prevent bleeding after polypectomy. In our experience, most clips usually detach within a week. There are no previous reports dealing with the outcomes of clip use. Furthermore, it has been unclear whether clips are truly effective especially in preventing hemorrhage. Therefore, in the present study the risk factors associated with bleeding after polypectomy were identitied and correlation between hemorrhages and the use of clips was determined. Methods : One hundred and sixty five cases were enrolled in our study. Colonoscopy was done on the day after polypectomy to determine it bleeding had occurred from the ulcers or the area around the ulcers. The number of clips that were still present was noted. The association of bleeding with the polyp's clinicopathological features, type of removal, and the parameters related to the clips was determined. Results : No patient had hematochezia prior to colonoscopy ; however, on post-procedure colonoscopy, 9 (2.9%) had oozing from ulcers and 39 (12.7%) had oozing from around ulcers. Hemorrhage risk factors included a positive biopsy, polyps 710 mm in size, piecemeal EMR, and the presence of bleeding episode during EMR. 87% of the clips were still present on the day post-procedure, and in the cases in whom the clips had detached coagulated areas were seen. Conclusions : After colonoscopic polypectomy patients must be assessed for bleeding. When using clips, it is necessary to grasp the visible vessels or the mucosa that surrounds the ulcers tightly : the vessel should not be dropped, since this can induce bleeding.
