Incidence and Management of Hemorrhage after Endoscopic Removal of Colorectal Lesions

抄録

Thirty bleeding cases after therapeutic endoscopy for 2916 colorectal lesions were analyzed. The therapeutic endoscopy method, size of lesions, anatomic location, latency between endoscopic therapy and rectal bleeding were recorded for each case. The bleeding rate by hot biopsy was 0.4% (5 lesions), by polypectomy 1.4% (20 lesions) and by endoscopic mucosal resection 1.7% (5 lesions) . The bleeding rate was associated with the size of the colorectal polyp. Sessile lesions on the cecum and ascending colon had the highest incidence of bleeding after therapeutic endoscopy. Pedunculated lesions bled more than any other lesions in the rectosigmoid region. A 93% bleeding rate was recognized within the ninth day after therapeutic endoscopy. Endoscopic clipping was the most effective for bleeding after endoscopic resection. None of our cases underwent surgical operation for bleeding after endoscopic resection. Based on these results, we would perform endoscopic clipping to prevent bleeding after removal of any lesion more than 1.0cm in size, such as a sessile lesion on the cecum and ascending colon, or a pedunculated lesion on the rectosigmoid region.