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Risk Factors for Delayed Post Polypectomy Bleeding Following Colonoscopic Polypectomy: A Study of 1073 Cases

Received: 9 August 2021    Accepted: 27 August 2021    Published: 30 September 2021
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Abstract

Background: Bleeding occurs in approximately 1.0−6.1% cases of endoscopic polypectomy. Bleeding can be immediate or delayed. The incidence of delayed post polypectomy bleeding ranges from 0.4% to 1.1%. This study aims at identifying risk factors for delayed post polypectomy bleeding. Methods: A retrospective study was carried out to evaluate the risk factors of delayed Post Polypectomy Bleeding following colonoscopic polypectomy. Patient who had post polypectomy bleeding were assigned to the case group. These patients were age and sex-matched to 57 randomly selected control patients who didn’t have post polypectomy bleeding after colonoscopic polypectomy. The baseline characteristics of the case and control groups were similar. No significant differences were identified between the two groups of patients in terms of demographic characteristics, laboratory findings, and comorbidities. Different characteristics of the patients and their polyps (size, location, shape, and histopathological findings) were compared between the case and control group using Chi-square(X2) test. Odds ratio (OR) was calculated for each risk factor to be evaluated. A p-value <0.05 was considered as significant. Statistical analysis was done with SPSS v22. Result: Among the 1073 patients who underwent colonoscopic polypectomy during the study period, 19 (1.77%) experienced delayed PPB. A polyp size of more than 10mm showed significant association with occurrence of delayed PPB with an OR of 6.7. Sessile polyps were more likely to be associated with delayed PPB with an OR of 4.4. Polyps located at the right colon were more prone to delayed PPB with an OR of 4.7. Obese patients with a BMI of more than 25 were more likely to have delayed PPB with an OR of 6.6. Patients aged more than 65 years, patients having cardiovascular disease & patients having CKD were more likely to have delayed PPB in comparison with those who didn’t have these comorbidities. Conclusion: The incidence of delayed PPB was 1.77% in our study, and patients with large polyps (>10mm), sessile polyps & polyps located in the right hemi colon showed an increased risk of delayed PPB. In addition, patients with higher BMI (>25) also showed a higher risk of delayed PPB. Patients aged more than 65 years, patients having cardiovascular disease & patients having CKD were more likely to have delayed PPB in comparison with those who didn’t have these comorbidities. Polypectomies in patients with these risk factors carry high risk of delayed PPB and should always be delt with extra precaution.

Published in International Journal of Gastroenterology (Volume 5, Issue 2)
DOI 10.11648/j.ijg.20210502.15
Page(s) 62-67
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Risk Factors, Delayed Post Polypectomy Bleeding (PPB), Colonoscopic Polypectomy

References
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[3] Zauber AG, Winawer SJ, O’Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012; 366: 687-696.
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  • APA Style

    Khan Mohammad Nazmus Saqeb, Mohammad Shamsul Arfin. (2021). Risk Factors for Delayed Post Polypectomy Bleeding Following Colonoscopic Polypectomy: A Study of 1073 Cases. International Journal of Gastroenterology, 5(2), 62-67. https://doi.org/10.11648/j.ijg.20210502.15

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    ACS Style

    Khan Mohammad Nazmus Saqeb; Mohammad Shamsul Arfin. Risk Factors for Delayed Post Polypectomy Bleeding Following Colonoscopic Polypectomy: A Study of 1073 Cases. Int. J. Gastroenterol. 2021, 5(2), 62-67. doi: 10.11648/j.ijg.20210502.15

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    AMA Style

    Khan Mohammad Nazmus Saqeb, Mohammad Shamsul Arfin. Risk Factors for Delayed Post Polypectomy Bleeding Following Colonoscopic Polypectomy: A Study of 1073 Cases. Int J Gastroenterol. 2021;5(2):62-67. doi: 10.11648/j.ijg.20210502.15

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  • @article{10.11648/j.ijg.20210502.15,
      author = {Khan Mohammad Nazmus Saqeb and Mohammad Shamsul Arfin},
      title = {Risk Factors for Delayed Post Polypectomy Bleeding Following Colonoscopic Polypectomy: A Study of 1073 Cases},
      journal = {International Journal of Gastroenterology},
      volume = {5},
      number = {2},
      pages = {62-67},
      doi = {10.11648/j.ijg.20210502.15},
      url = {https://doi.org/10.11648/j.ijg.20210502.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20210502.15},
      abstract = {Background: Bleeding occurs in approximately 1.0−6.1% cases of endoscopic polypectomy. Bleeding can be immediate or delayed. The incidence of delayed post polypectomy bleeding ranges from 0.4% to 1.1%. This study aims at identifying risk factors for delayed post polypectomy bleeding. Methods: A retrospective study was carried out to evaluate the risk factors of delayed Post Polypectomy Bleeding following colonoscopic polypectomy. Patient who had post polypectomy bleeding were assigned to the case group. These patients were age and sex-matched to 57 randomly selected control patients who didn’t have post polypectomy bleeding after colonoscopic polypectomy. The baseline characteristics of the case and control groups were similar. No significant differences were identified between the two groups of patients in terms of demographic characteristics, laboratory findings, and comorbidities. Different characteristics of the patients and their polyps (size, location, shape, and histopathological findings) were compared between the case and control group using Chi-square(X2) test. Odds ratio (OR) was calculated for each risk factor to be evaluated. A p-value 10mm), sessile polyps & polyps located in the right hemi colon showed an increased risk of delayed PPB. In addition, patients with higher BMI (>25) also showed a higher risk of delayed PPB. Patients aged more than 65 years, patients having cardiovascular disease & patients having CKD were more likely to have delayed PPB in comparison with those who didn’t have these comorbidities. Polypectomies in patients with these risk factors carry high risk of delayed PPB and should always be delt with extra precaution.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Risk Factors for Delayed Post Polypectomy Bleeding Following Colonoscopic Polypectomy: A Study of 1073 Cases
    AU  - Khan Mohammad Nazmus Saqeb
    AU  - Mohammad Shamsul Arfin
    Y1  - 2021/09/30
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijg.20210502.15
    DO  - 10.11648/j.ijg.20210502.15
    T2  - International Journal of Gastroenterology
    JF  - International Journal of Gastroenterology
    JO  - International Journal of Gastroenterology
    SP  - 62
    EP  - 67
    PB  - Science Publishing Group
    SN  - 2640-169X
    UR  - https://doi.org/10.11648/j.ijg.20210502.15
    AB  - Background: Bleeding occurs in approximately 1.0−6.1% cases of endoscopic polypectomy. Bleeding can be immediate or delayed. The incidence of delayed post polypectomy bleeding ranges from 0.4% to 1.1%. This study aims at identifying risk factors for delayed post polypectomy bleeding. Methods: A retrospective study was carried out to evaluate the risk factors of delayed Post Polypectomy Bleeding following colonoscopic polypectomy. Patient who had post polypectomy bleeding were assigned to the case group. These patients were age and sex-matched to 57 randomly selected control patients who didn’t have post polypectomy bleeding after colonoscopic polypectomy. The baseline characteristics of the case and control groups were similar. No significant differences were identified between the two groups of patients in terms of demographic characteristics, laboratory findings, and comorbidities. Different characteristics of the patients and their polyps (size, location, shape, and histopathological findings) were compared between the case and control group using Chi-square(X2) test. Odds ratio (OR) was calculated for each risk factor to be evaluated. A p-value 10mm), sessile polyps & polyps located in the right hemi colon showed an increased risk of delayed PPB. In addition, patients with higher BMI (>25) also showed a higher risk of delayed PPB. Patients aged more than 65 years, patients having cardiovascular disease & patients having CKD were more likely to have delayed PPB in comparison with those who didn’t have these comorbidities. Polypectomies in patients with these risk factors carry high risk of delayed PPB and should always be delt with extra precaution.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of Gastrointestinal, Hepatobiliary & Pancreatic Diseases, Jahurul Islam Medical College & Hospital, Kishoreganj, Bangladesh

  • Department of Gastrointestinal, Hepatobiliary & Pancreatic Diseases, Bangladesh Specialized Hospital, Dhaka, Bangladesh

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