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  • Title: Incidence and predictors of postpolypectomy bleeding in colorectal polyps larger than 10 mm.
    Author: Gimeno-García AZ, de Ganzo ZA, Sosa AJ, Pérez DN, Quintero E.
    Journal: Eur J Gastroenterol Hepatol; 2012 May; 24(5):520-6. PubMed ID: 22465971.
    Abstract:
    BACKGROUND: It is well-established that the risk of postpolypectomy bleeding (PPB) increases with polyp size, but little is known about the factors that predict PPB in polyps larger than 10 mm. AIM: The aim of this study is to assess the incidence and risk factors for PPB in colorectal polyps larger than 10 mm. METHODS: A historical cohort study was carried out in an open access endoscopy unit from January 2007 to December 2008. Endoscopic polypectomy was performed in 1894 (28%) patients. Clinical records of patients with polyps of at least 10 mm were reviewed. Data on demographics, comorbidity, polyp-related features, and resection technique were collected. The incidence of immediate bleeding (during polypectomy) and delayed bleeding (up to 1 month later) was assessed. RESULTS: A total of 424 large polyps (median size=12 mm; P₂₅-P₇₅: 10-16 mm) were resected. Thirty-five episodes of PPB occurred in 33 (7.8%) polyps, of which 12 (2.8%) were delayed. Multivariate logistic regression analysis demonstrated that a polyp size of at least 14 mm was the most important predictor of PPB [odds ratio (OR) 3.17, 95% confidence interval (CI) 1.492-6.751, P=0.003], compared with the presence of a villous architecture (OR 2.23, 95% CI 1.056-4.705, P=0.035) or high-grade dysplasia (OR 2.96, 95% CI 1.305-6.692, P=0.009). CONCLUSION: In the current study, the rate of PPB was almost 8% in polyps larger than 10 mm, occurring in most cases during the endoscopic procedure. A polyp of size at least 14 mm was the most important predictor for PPB. Prospective studies are needed to determine whether preventive endoscopic therapy may reduce PPB in these patients.
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