title: Prophylactic argon plasma coagulation ablation does not decrease delayed postpolypectomy bleeding.
abstract: BACKGROUND
  The most common complication of colonoscopic polypectomy is postpolypectomy bleeding (PPB). However, there are no established guidelines for the prevention of delayed PPB. It is possible that submucosal vessels of an artificial ulcer are a potential source of delayed bleeding that occurs several days after polypectomy.
  
  
  OBJECTIVE
  The aim of this randomized, controlled study was to evaluate the efficacy of prophylactic argon plasma coagulation (APC) of nonbleeding visible vessels in preventing delayed PPB.
  
  
  METHODS
  A prospective, randomized, controlled study.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  A total of 987 polyps in 600 consecutive patients were resected by colonoscopic polypectomy.
  
  
  METHODS
  In patients who underwent APC (APC group), all nonbleeding visible vessels on the ulcer crater were targeted and were then coagulated by APC ablation until they disappeared, but not in patients who did not undergo APC (control group).
  
  
  METHODS
  The incidence of delayed PPB in the APC group was compared with that in the control group.
  
  
  RESULTS
  Delayed PPB occurred in 3.3% (16/475) of all the patients, including 2.5% (6/240) in the APC group and 4.3% (10/235) in the control group. No significant differences were observed between the 2 groups in the rates of delayed PPB, irrespective of the type of delayed bleeding (significant bleeding: 0.8% [2/240] vs 1.3% [3/235], P = .638; minor bleeding: 1.7% [4/240] vs 3% [7/235], P = .378). There were no significant APC-related complications.
  
  
  CONCLUSIONS
  Single-center study.
  
  
  CONCLUSIONS
  Prophylactic APC ablation does not appear to have an additional advantage in the prevention of delayed PPB.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.
authors.forename: Chang Kyun
authors.initials: CK
authors.lastname: Lee
authors.forename: Suck-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Park
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Il-Kwun
authors.initials: IK
authors.lastname: Chung
authors.forename: Sang-Heum
authors.initials: SH
authors.lastname: Park
authors.forename: Hong-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sun-Joo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D001128:Argon; D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D001128:Argon