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Highlights from the March GIE: Gastrointestinal Endoscopy special issue on colorectal cancer
Date:3/19/2013

ete capture of complications.

This study's objective was to evaluate the effect of prophylactic clip closure of polypectomy sites after resection of large (≥ 2 cm) sessile and flat colorectal lesions. The study was performed at the tertiary care endoscopy unit at Indiana University Hospital. Patients with lesions 2 cm or larger who underwent endoscopic mucosal resection (EMR) performed by using low-power coagulation current between January 2000 and February 2012 participated in the study. Beginning in June 2006, polypectomy sites were prophylactically closed with clips when possible.

The main outcome measurements were delayed hemorrhage, postpolypectomy syndrome and perforation. There were 524 lesions 2 cm or larger in 463 patients, of which 247 (47.1 percent) were not clipped, 52 (9.9 percent) were partially clipped, and 225 (42.9 percent) were fully clipped. There were 31 delayed hemorrhages, two perforations, and six cases of postpolypectomy syndrome. The delayed hemorrhage rate was 9.7 percent in the not clipped group versus 1.8 percent in the fully clipped group. Multivariate analysis showed that not clipping, location proximal to the splenic flexure and polyp size were associated with delayed bleeding.

The researchers concluded that prophylactic clipping of resection sites after endoscopic removal of large (≥ 2 cm) colorectal lesions using low-power coagulation current reduced the risk of delayed postpolypectomy hemorrhage. A randomized, prospective trial of clipping large polypectomy sites is warranted.

Guideline

Also in the issue is the updated guideline "The role of endoscopy in the assessment and treatment of esophageal cancer."


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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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