Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023;41(5):729-736.
doi: 10.1159/000531061. Epub 2023 May 15.

Safety of Cold Snare Polypectomy during Continuous Use of Antithrombotic Drugs for Delayed Post-Polypectomy Bleeding: A Pilot Study

Junnosuke Hayasaka  1 , Satoshi Yamashita  1 , Akira Matsui  1 , Yusuke Kawai  1 , Yorinari Ochiai  1 , Takayuki Okamura  1 , Yugo Suzuki  1 , Yutaka Mitsunaga  1 , Kosuke Nomura  1 , Masami Tanaka  1 , Kazuhiro Fuchinoue  1 , Hiroyuki Odagiri  1 , Daisuke Kikuchi  1 , Yutaka Takazawa  2 , Shu Hoteya  1
Affiliations

Safety of Cold Snare Polypectomy during Continuous Use of Antithrombotic Drugs for Delayed Post-Polypectomy Bleeding: A Pilot Study

Junnosuke Hayasaka et al. Dig Dis. 2023.

Abstract

Background: Cold snare polypectomy is a high-risk endoscopic procedure with a low delayed post-polypectomy bleeding rate. However, it is unclear whether delayed post-polypectomy bleeding rates increase during continuous antithrombotic treatment. This study aimed to determine the safety of cold snare polypectomy during continuous antithrombotic treatment.

Methods: This single-center, retrospective cohort study enrolled patients who underwent cold snare polypectomy during antithrombotic treatment between January 2015 and December 2021. Patients were divided into continuation and withdrawal groups based on whether they continued with antithrombotic drugs or not. Propensity score matching was performed using age, sex, Charlson comorbidity index, hospitalization, scheduled treatment, type of antithrombotic drugs used, multiple medications used, indication for antithrombotic drugs, and gastrointestinal endoscopist qualifications. The delayed polypectomy bleeding rates were compared between the groups. Delayed polypectomy bleeding was defined as the presence of blood in stools and requiring endoscopic treatment or a decrease in hemoglobin level by 2 g/dL or more.

Results: The continuation and withdrawal groups included 134 and 294 patients, respectively. Delayed polypectomy bleeding was observed in 2 patients (1.5%) and 1 patient (0.3%) in the continuation and withdrawal groups, respectively (p = 0.23), before propensity score matching, with no significant difference. After propensity score matching, delayed polypectomy bleeding was observed in 1 patient (0.9%) in the continuation group but not in the withdrawal group, with no significant difference.

Conclusion: Cold snare polypectomy during continuous antithrombotic treatment did not significantly increase delayed post-polypectomy bleeding rates. Therefore, this procedure may be safe during continuous antithrombotic treatment.

Keywords: Antithrombotic drug; Cold snare polypectomy; Colon polyp; Colonoscopy; Delayed post-polypectomy bleeding.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Similar articles

See all similar articles

Cited by

  • Delphi consensus statement for the management of delayed post-polypectomy bleeding.
    Rodríguez de Santiago E, Pérez de la Iglesia S, de Frutos D, Marín-Gabriel JC, Mangas-SanJuan C, Honrubia López R, Uchima H, Aicart-Ramos M, Rodríguez Gandía MÁ, Valdivielso Cortázar E, Ramos Zabala F, Álvarez MA, Solano Sánchez M, González Santiago JM, Albéniz E, Hijos-Mallada G, Castro Quismondo N, Fraile-López M, Martínez Ares D, Tejedor-Tejada J, Hernández L, Gornals JB, Quintana-Carbo S, Ocaña J, Cunha Neves JA, Martínez Martínez J, López-Cerón Pinilla M, Dolz Abadía C, Pellisé M. Rodríguez de Santiago E, et al. Therap Adv Gastroenterol. 2025 Apr 21;18:17562848251329145. doi: 10.1177/17562848251329145. eCollection 2025. Therap Adv Gastroenterol. 2025. PMID: 40297208 Free PMC article.

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020 GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. - PubMed
    1. Winawer SJ, Zauber AG, Ho MN, O'Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The national polyp study workgroup. N Engl J Med. 1993;329(27):1977–1981. - PubMed
    1. Winawer SJ, Zauber AG, O'Brien MJ, Ho MN, Gottlieb L, Sternberg SS, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The national polyp study workgroup. N Engl J Med. 1993;328(13):901–906. - PubMed
    1. Zauber AG, Winawer SJ, O'Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366(8):687–696. - PMC - PubMed
    1. Heldwein W, Dollhopf M, Rösch T, Meining A, Schmidtsdorff G, Hasford J, et al. The Munich polypectomy study (MUPS) prospective analysis of complications and risk factors in 4,000 colonic snare polypectomies. Endoscopy. 2005;37(11):1116–1122. - PubMed

Substances