title: Do We Perform a Perfect Endoscopic Hemostasis Prophylactically with Argon Plasma Coagulation in Colonic Endoscopic Mucosal Resection?
abstract: BACKGROUND
  Submucosal injection for endoscopic mucosal resection (EMR) may effect performing the prophylactic argon plasma coagulation (APC) of non-bleeding visible vessels on ulcer crater.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the clinical features of visible vessels in iatrogenic ulcers over time after prophylactic APC in colonic EMR.
  
  
  METHODS
  This study was designed as a prospective study. Between August and November 2013, a total of 40 patients who were admitted underwent prophylactic APC for non-bleeding visible vessels after colonic EMR. After confirming whether visible vessels were completely coagulated or not, the number of visible vessels in ulcers was counted over a specific time period, e.g. 1, 3, 5, or 7 min.
  
  
  RESULTS
  The mean number of visible vessels was significantly higher at 5 min (0.85 ± 1.14) after EMR with prophylactic APC compared to 1 and 3 min (1 min: 0.28 ± 0.60, P < 0.001; 3 min: 0.65 ± 0.87, P = 0.02) and there was no significant difference between 5 and 7 min (P = 0.31). Multivariate analysis showed that the size of the iatrogenic ulcer after EMR was associated with the occurrence of visible vessels (ulcer size >1 vs. ≤0.5 cm: OR 27.32, 95% CI 2.86-infinity).
  
  
  CONCLUSIONS
  A 5-min observation of the ulcer may be advantageous for the assessment of visible vessels after performing colonic EMR with prophylactic APC, and large (>1 cm) iatrogenic ulcers were associated with the occurrence of visible vessels after colonic EMR.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, 23-20 Bongmyung-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Korea.
authors.forename: Yunho
authors.initials: Y
authors.lastname: Jung
authors.affiliation: Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, 23-20 Bongmyung-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Korea. euschung@schmc.ac.kr.
authors.forename: Il Kwun
authors.initials: IK
authors.lastname: Chung
authors.affiliation: Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, 23-20 Bongmyung-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Korea.
authors.forename: Young Sin
authors.initials: YS
authors.lastname: Cho
authors.affiliation: Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, 23-20 Bongmyung-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, 23-20 Bongmyung-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Korea.
authors.forename: Sang-Heum
authors.initials: SH
authors.lastname: Park
authors.affiliation: Clinical Research Center, Asan Medical Center, Seoul, Korea.
authors.forename: Ji Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, 23-20 Bongmyung-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Korea.
authors.forename: Sun Joo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D057908:Argon Plasma Coagulation / Q000379:methods*; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D019106:Postoperative Hemorrhage / Q000517:prevention & control* / Q000628:therapy; D011446:Prospective Studies; D011786:Quality Control; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: Bleeding; Endoscopic mucosal resection; Polypectomy