Delayed Bleeding After Endoscopic Resection of Colorectal Polyps: Identifying High-Risk Patients.
Bendall, Oliver James, Joel Pawlak, Katarzyna M Ishaq, Sauid Tau, J Andy Suzuki, Noriko Bollipo, Steven Siau, Keith
Bendall, Oliver
James, Joel
Pawlak, Katarzyna M
Ishaq, Sauid
Tau, J Andy
Suzuki, Noriko
Bollipo, Steven
Siau, Keith
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Affiliation
Royal Cornwall Hospitals NHS Trust; Ministry of Interior and Administration, Szczecin; Dudley Group Hospitals NHS Foundation Trust; Sandwell and West Birmingham NHS Trust
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Publication date
2021-12-24
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Abstract
Delayed post-polypectomy bleeding (DPPB) is a potentially severe complication of therapeutic colonoscopy which can result in hospital readmission and re-intervention. Over the last decade, rates of DPPB reported in the literature have fallen from over 2% to 0.3-1.2%, largely due to improvements in resection technique, a shift towards cold snare polypectomy, better training, adherence to guidelines on periprocedural antithrombotic management, and the use of antithrombotics with more favourable bleeding profiles. However, as the complexity of polypectomy undertaken worldwide increases, so does the importance of identifying patients at increased risk of DPPB. Risk factors can be categorised according to patient, polyp and personnel related factors, and their integration together to provide an individualised risk score is an evolving field. Strategies to reduce DPPB include safe practices relevant to all patients undergoing colonoscopy, as well as specific considerations for patients identified to be high risk. This narrative review sets out an evidence-based summary of factors that contribute to the risk of DPPB before discussing pragmatic interventions to mitigate their risk and improve patient safety.
Citation
Bendall, O., James, J., Pawlak, K. M., Ishaq, S., Tau, J. A., Suzuki, N., Bollipo, S., & Siau, K. (2021). Delayed Bleeding After Endoscopic Resection of Colorectal Polyps: Identifying High-Risk Patients. Clinical and experimental gastroenterology, 14, 477–492. https://doi.org/10.2147/CEG.S282699
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Article