Search
DEEN
more info

Contact:
Phone:+49 0761 1514 440Fax:+49 0761 1514 460Email:info[at]falkfoundation.org

    Colon to Rectum

    Clin Gastroenterol Hepatol. 2022;20(2):362–71.e23

    Turan AS, Pohl H, Matsumoto M, Lee BS, Aizawa M, Desideri F, Albéniz E, Raju GS, Luba D, Barret M, Gurudu SR, Ramirez FC, Lin WR, Atsma F, Siersema PD, van Geenen EJM; Prophylactic Clipping Collaborative Group

    The role of clips in preventing delayed bleeding after colorectal polyp resection: An individual patient data meta-analysis


    Background and aims: Non-pedunculated colorectal polyps are normally endoscopically removed to prevent neoplastic progression. Delayed bleeding is the most common major adverse event. Clipping the resection defect has been suggested to reduce delayed bleedings. The aim of this study was to determine if prophylactic clipping reduces delayed bleedings and to analyze the contribution of polyp characteristics, extent of defect closure, and antithrombotic use.
    Methods: An individual patient data meta-analysis was performed. Studies on prophylactic clipping in non-pedunculated colorectal polyps were selected from PubMed, Embase, Web of Science, and Cochrane database (last selection, April 2020). Authors were invited to share original study data. The primary outcome was delayed bleeding ≤ 30 days. Multivariable mixed models were used to determine the efficacy of prophylactic clipping in various subgroups adjusted for confounders.
    Results: Data of 5380 patients with 8948 resected polyps were included from 3 randomized controlled trials, 2 prospective, and 8 retrospective studies. Prophylactic clipping reduced delayed bleeding in proximal polyps ≥ 20 mm (odds ratio [OR] = 0.62; 95% confidence interval [CI]: 0.44–0.88; number needed to treat [NNT] = 32), especially with antithrombotics (OR = 0.59; 95% CI: 0.35–0.99; NNT = 23; subgroup of anticoagulants/double platelet inhibitors: n = 226; OR = 0.40; 95% CI: 0.16–1.01; NNT = 12). Prophylactic clipping did not benefit distal polyps ≥ 20 mm with antithrombotics (OR = 1.41; 95% CI: 0.79–2.52).

    Conclusions: Prophylactic clipping reduces delayed bleeding after resection of non-pedunculated, proximal colorectal polyps ≥ 20 mm, especially in patients using antithrombotics. No benefit was found for distal polyps. Based on this study, patients can be identified who may benefit from prophylactic clipping

    Dr. A.S. Turan, Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands,
    E-Mail: aylaturan@radboudumc.nl

    DOI: DOI: 10.1016/j.cgh.2021.05.012

    Back to overview

    this could be of interest:

    Colon to Rectum

    SER-109, an oral microbiome therapy for recurrent Clostridioides difficile infection

    N Engl J Med. 2022;386(3):220–9

    Feuerstadt P, Louie TJ, Lashner B, Wang EEL, Diao L, Bryant JA, Sims M, Kraft CS, Cohen SH, Berenson CS, Korman LY, Ford CB, Litcofsky KD, Lombardo MJ, Wortman JR, Wu H, Auniņš JG, McChalicher CWJ, Winkler JA, McGovern BH, Trucksis M, Henn MR, von Moltke L

    Go to article

    Colon to Rectum

    Antibiotic use differentially affects the risk of anti-drug antibody formation during anti-TNFα therapy in inflammatory bowel disease patients: A report from the epi-IIRN

    Gut. 2022;71(2):287–95

    Gorelik Y, Freilich S, Gerassy-Vainberg S, Pressman S, Friss C, Blatt A, Focht G, Loewenberg Weisband Y, Greenfeld S, Kariv R, Lederman N, Dotan I, Geva-Zatorsky N, Shen-Orr SS, Kashi Y, Chowers Y; Israeli IBD research nucleus (IIRN)

    Go to article
    More articles on the topic