Endoscopy 2018; 50(04): S175
DOI: 10.1055/s-0038-1637570
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

INDICATIONS FOR COLONOSCOPY SURVEILLANCE IN THE MANAGEMENT OF POST-POLYPECTOMY BLEEDING

M Hernandez-Tejero
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
L Rivero-Sanchez
2   Hospital Clínic, University of Barcelona, Department of Gastroenterology and Endoscopy Unit CIBERehd, IDIBAPS, Barcelona, Spain
,
L Llovet
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
G Jung
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
P Olivas
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
O Ortiz
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
O Sendino
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
H Córdova
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
J Llach
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
,
M Pellise
1   Hospital Clinic, Department of Gastroenterology and Digestive Endoscopy Unit, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available ateRef
 

Aims:

Postpolypectomy bleeding (PPB) is the most common complication of colonoscopic polypectomy. The treatment algorithm for the management of PPB is not well established. We aim to evaluate the indications for colonoscopy in the treatment of PPB.

Methods:

This was a retrospective, observational, unicentric study. All patients diagnosed with PPB between 2010 and 2015 were included. Data with regards to clinical characteristics, index colonoscopy and medical management of PPB were collected. The presence of active bleeding, visible vessel and/or adherent clot over the polypectomy ulcer were considered significant lesions (SigL) of PPB.

Results:

A sample of sixty-six patients with PPB was initially included. Six of them, which underwent angiography+embolization, were excluded. No deaths or surgeries were reported. Fifty-three percent of patients (32/60) underwent a colonoscopy whereas no procedure was performed in the remaining 47% (28/60). A decrease in hemoglobin≥2 g/dL (p = 0.002; OR = 30.6; CI 95% 3.69 – 253.21) was indentified as an independent risk factor to perform a colonoscopy. Of the thirty-two patients who underwent a colonoscopy, fifteen (56.9%) had SigL while seventeen (53.1%) had non-significant lesions (fibrin or hematin). When a prophylactic technique during polypectomy (p = 0.036; OR = 18.7; CI 95% 1.21 – 288.80) was not performed and the bleeding onset was less than< 48h (p = 0.026; OR = 10.57; CI 95% 1.32 – 84.19), these were independently associated with the finding of LSig. None of the patients with non-significant lesions presented active bleeding (clots/fresh blood) during the preparation of the colonoscopy.

Conclusions:

Patients with PPB who can benefit from a therapeutic colonoscopy are those with a hemoglobin decrease≥2 g/dL and a bleeding onset less than 48 hours. The absence of clots or fresh blood during the preparation could be an indicator to manage the PPB without performing a colonoscopy.