Colonic Postpolypectomy Bleeding Is Related to Polyp Size and Heparin Use.
OBJECTIVE
We studied factors influencing colon postpolypectomy bleeding (PPB), with a focus on antithrombotic and anticoagulation therapy.


METHODS
We conducted a retrospective case-control study of all patients who underwent polypectomy at our tertiary referral center in Italy between 2007 and 2014. Polyp characteristics (number of polyps removed per patient, size, morphology, location, resection technique, prophylactic hemostasis methods) and patient characteristics (age, sex, comorbidities, medication) were analyzed.


RESULTS
The case and control groups included 118 and 539 patients, respectively. The two groups differed in the frequency of comorbidities (69% vs. 40%,p=0.001), polyps removed (27% vs. 18%,p=0.02), and use of heparin therapy (23% vs. 1%,p<0.001). A total of 279 polyps in the case group and 966 in the control group were nonpedunculated (69% vs. 81%,p=0.01) and measured ≥10 mm (78% vs. 32%,p=0.001). Multivariate analysis showed that polyps ≥10 mm (odds ratio [OR], 6.1; 95% confidence interval [CI], 2.3-15.5), administration of heparin (OR, 16.5; 95% CI, 6.2-44), comorbidity (OR, 2.3; 95% CI, 1.4-3.9), and presence of ≥2 risk factors (OR, 3.2; 95% CI, 1.7-6.0) were associated with PPB.


CONCLUSIONS
The incidence of PPB increases with polyp size ≥10 mm, heparin use, comorbidity, and presence of ≥2 risk factors.
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Flavia
F
Pigò
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Helga
H
Bertani
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Mauro
M
Manno
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Vincenzo Giorgio
VG
Mirante
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Angelo
A
Caruso
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Santi
S
Mangiafico
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Raffaele
R
Manta
Internal Medicine Department, Vignola Hospital, Vignola, Modena, Italy.
Anna Maria
AM
Rebecchi
Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy.
Rita Luisa
RL
Conigliaro
Colonoscopy; Hemorrhage; Humans; Postpolypectomy bleeding