Influence of prophylactic local administration of epinephrine on bleeding complications after polypectomy

Abstract

Background and study aims: Data concerning the potential benefit of local application of vasoconstricting substances prior to snare excision of colonic polyps are scarce. The influence of prophylactic submucosal injection of epinephrine in the prevention of hemorrhage after polypectomy was therefore evaluated in larger polyps.

Patients and methods: Seventy-three patients, in whom 77 polyps more than 15 mm in diameter had been excised during a 30-month period, were included in this retrospective analysis. Twenty-eight polyps were excised with prophylactic injection of epinephrine into the polyp base, and 49 polyps were excised without the injection. All data were retrieved by reviewing the medical records.

Results: No bleeding occurred in the epinephrine group (28 polyps). In contrast, nine of the 49 polypectomies that were carried out without prior administration of epinephrine were associated with a bleeding episode (P = 0.015).

Conclusions: Local injection therapy appears to reduce the risk of bleeding after the excision of larger polyps. Controlled trials are warranted in order to provide conclusive evidence concerning the prophylactic effect of epinephrine on hemorrhage after polypectomy.