Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy.
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.
Dobrowolski
Sebastian
S
Department of General, Endocrinological and Transplantation Surgery, Medical Academy of Gdansk, Witosa 21/30, Gdansk 80-809, Poland.
Dobosz
Marek
M
Babicki
Andrzej
A
Głowacki
Janusz
J
Nałecz
Adam
A
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