Predictors for emergency hemostasis in patients with colonoscopic delayed post-polypectomy bleeding

Abstract

Background: In patients with delayed post-polypectomy bleeding (DPPB), the difference between patients who undergo emergency endoscopic hemostasis and observation is unknown. This study aims to identify factors associated with emergency endoscopic hemostasis in patients with DPPB.

Methods: This study is a retrospective single-center case-control study conducted at Toyoshima Endoscopy Clinic. Patients with DPPB between 2018 and 2022 were enrolled. Patient age, sex, resected polyps (number, diameter, and morphology), and endoscopic procedure (endoscopic mucosal resection [EMR] and clipping) were compared between patients who underwent hemostasis and observation. A binomial logistic analysis was used.

Results: A total of 52 patients (mean age 54.1 years, men 53.8%) with DPPB were eligible. Thirty-eight (73.1%) and 14 (26.9%) patients underwent hemostasis and observation, respectively. Male sex (63.2% vs. 28.6%), larger total polyp diameter (16.6 mm vs. 11.3 mm), larger max polyp diameter (9.9 mm vs. 6.7 mm), inclusion of 0-I type polyp (94.7% vs. 50.0%), and inclusion of EMR (63.2% vs. 14.3%) were associated with hemostasis compared to observation.

Conclusions: In patients with DPPB, the need for hemostasis should be considered with regard to male sex, large polyp size, 0-I morphology, and EMR. Prospective studies are warranted in the future.