Clin Endosc.  2012 Mar;45(1):84-88. 10.5946/ce.2012.45.1.84.

Clipping for the Prevention of Immediate Bleeding after Polypectomy of Pedunculated Polyps: A Pilot Study

Affiliations
  • 1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jsbyeon@amc.seoul.kr
  • 2Department of Gastroenterology, Chonnam National University Medical School, Gwangju, Korea.
  • 3Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
  • 4Department of Gastroenterology, Pusan National University School of Medicine, Busan, Korea.

Abstract

BACKGROUND/AIMS
Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB.
METHODS
This is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated.
RESULTS
Fifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56+/-11 years) were included. The size of the polyp heads was 17+/-8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2+/-0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred.
CONCLUSIONS
We suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.

Keyword

Pedunculated polyp; Polypectomy; Clip; Bleeding
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