Risk factors for delayed hemorrhage after colonoscopic postpolypectomy: Polyp size and operative modality

Abstract

Background and aim: Delayed postpolypectomy hemorrhage is relatively common, with occasional extensive blood loss, endangering life. This study aimed to determine the factors associated with postoperative hemorrhage.

Methods: The study was a retrospective cohort study of patients hospitalized for colonoscopic polypectomy at the Department of Gastroenterology and Hepatology, Tenth People's Hospital of Tongji University, China, between January and December 2015. Data on gender, age, bowel preparation, location, size, number of polyps, operative modality, pathology, and operation practitioner were collected. Patients were divided into two groups based on the presence or absence of postoperative hemorrhage.

Results: A total of 1962 polyps were detected in patients and they underwent polypectomy; hemorrhage occurred in 41 cases. A correlation was demonstrated between postpolypectomy hemorrhage and each of the following factors: polyp size and operative modality. The odds ratio (OR) was 4.535 (95% confidence interval [CI], 2.331-8.823) for 1-2-cm polyps, 4.008 (95% CI, 0.904-17.776) for 2-3-cm polyps, and 22.407 (95% CI, 5.783-86.812) for ≥3-cm polyps. Compared with argon plasma coagulation, OR was 9.128 (95% CI, 3.548-23.486) for endoscopic mucosal resection and 31.257 (95% CI, 7.009-139.395) for endoscopic submucosal dissection.

Conclusions: The independent risk factors for delayed postpolypectomy hemorrhage include polyp size and operative modality.

Keywords: delayed postoperative hemorrhage; operative modality; polyp size; polypectomy.