Prophylactic hemoclips effective for prevention of bleeding in large polyps
Hemoclipping may be an effective prophylaxis for treatment of large pedunculated polyps, according to a study published in Gastrointestinal Endoscopy.
“To our knowledge this study was the first multicenter trial to investigate the efficacy of a prophylactic hemoclip on [postpolypectomy bleeding (PPB)] and demonstrated that prophylactic clipping could reduce overall PPB and [intermediate PPB (IPPB)] associated with resection of large pedunculated polyps,” Tae-Geun Gweon, MD, PhD, from the department of internal medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea in Seoul, Korea and colleagues wrote.
Gweon and colleagues identified 204 patients with 238 large pedunculated colonic polyps. Then they randomly assigned patients to either the study arm where they received the prophylactic hemoclip (HX-610-090L Olympus, Tokyo, Japan; n = 119) before resection or to the control arm (n=119) receiving no pretreatment before resection. The rate of postpolypectomy bleeding in each group served as the primary outcome. This included either immediate or delayed PPB.
“IPPB was defined as blood oozing (1 min) or active spurting occurring immediately after polyp resection,” Gweon and colleagues wrote. “DPPB was defined as rectal bleeding, occurring after completion of the colonoscopy. “
Investigators observed adverse events in 20 cases, 16 had IPPB and four had DPPB.
Results showed the rate of overall PPB was 8.4%, 6.7% for IPPB and 1.7% for DPPB.
“The rate of overall PPB (clip 4.2% vs. control 12.6%, P = .033) and IPPB (clip 2.5% vs. control 10.9%, P = .017) was significantly lower in the clip arm than the control arm,” the authors wrote.