title: Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy.
abstract: BACKGROUND
  The most common complication of endoscopic polypectomy is hemorrhage. Several factors have been reported to increase the risk of hemorrhage after polypectomy, but controversies still exist. Additionally, the pathomechanism of this complication is not well understood.
  
  
  OBJECTIVE
  To investigate the risk factors of colonoscopic postpolypectomy bleeding in patients without bleeding disorders and the blood supply of resected polyps.
  
  
  METHODS
  Two hundred forty-five patients (147 men, 98 women; median age, 62.8 +/- 9.5 years [SD]) with 283 colorectal polyps, measuring > or =1 cm in diameter, were included in this prospective study.
  
  
  METHODS
  The polypectomies were performed using the conventional endoscopic method. Data on the patients' age and sex, as well as polyp location, size, shape, and pathology findings were recorded. The patients were observed for bleeding complications. Microscopic examination of the vascular supply of the removed polyps was performed.
  
  
  RESULTS
  Twenty-nine postpolypectomy hemorrhages (10.2%) occurred. The bleeding rate correlated with the size, shape, and pathology results of resected polyps. The microscopic analysis revealed that sessile and thick-stalked pedunculated polyps are supplied with more vessels than other polyps.
  
  
  CONCLUSIONS
  Patients with polyps larger than 17 mm, pedunculated polyps with a stalk diameter >5 mm, sessile polyps, and malignant lesions of the colorectal region are at high risk of hemorrhage after endoscopic excision. Moreover, on the basis of microscopic study, broad-based polyps are supplied with a considerable number of blood vessels.
authors.affiliation: Department of General, Endocrinological and Transplantation Surgery, Medical Academy of Gdansk, Witosa 21/30, Gdansk 80-809, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Dobrowolski
authors.forename: Marek
authors.initials: M
authors.lastname: Dobosz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Babicki
authors.forename: Janusz
authors.initials: J
authors.lastname: Głowacki
authors.forename: Adam
authors.initials: A
authors.lastname: Nałecz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000098:blood supply; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology*; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors