Author:
Zhang Xuzhen,Jiang Xiaoxing,Shi Liang
Abstract
Abstract
Background
To systematically analyze risk factors for delayed postpolypectomy bleeding (DPPB) in colorectum.
Methods
We searched seven large databases from inception to July 2022 to identify studies that investigated risk factors for DPPB. The effect sizes were expressed by relative risk (RR) and 95% confidence interval (95% CI). The heterogeneity was analyzed by calculating I2 values and performing sensitivity analyses.
Results
A total of 15 articles involving 24,074 subjects were included in the study. The incidence of DPPB was found to be 0.02% (95% CI, 0.01–0.03), with an I2 value of 98%. Our analysis revealed that male sex (RR = 1.64), history of hypertension (RR = 1.54), anticoagulation (RR = 4.04), polyp size (RR = 1.19), polyp size ≥ 10 mm (RR = 2.43), polyp size > 10 mm (RR = 3.83), polyps located in the right semicolon (RR = 2.48) and endoscopic mucosal resection (RR = 2.99) were risk factors for DPPB.
Conclusions
Male sex, hypertension, anticoagulation, polyp size, polyp size ≥ 10 mm, polyps located in the right semicolon, and endoscopic mucosal resection were the risk factors for DPPB. Based on our findings, we recommend that endoscopists should fully consider and implement effective intervention measures to minimize the risk of DPPB.
Publisher
Springer Science and Business Media LLC
Reference27 articles.
1. Xirasagar S, Wu Y, Tsai MH, Zhang J, Chiodini S, de Groen PC. Colorectal cancer prevention by a CLEAR principles-based colonoscopy protocol: an observational study. Gastrointest Endosc. 2020;91(4):905–e164.
2. Dumoulin FL, Hildenbrand R. Endoscopic resection techniques for colorectal neoplasia: current developments. World J Gastroenterol. 2019;25(3):300–7.
3. Cheng P, Bo Y, Fang J, Zhao S, Wang S, Li N, et al. Risk factors of delayed colonoscopic post-polypectomy bleeding. Chin J Dig Endoscopy. 2018;35(5):332–5.
4. Kishida Y, Hotta K, Imai K, Ito S, Yoshida M, Kawata N, et al. Risk analysis of colorectal post-polypectomy bleeding due to Antithrombotic Agent. Digestion. 2019;99(2):148–56.
5. Kubo K, Kato M, Mabe K, Harada N, Iboshi Y, Kagaya T, et al. Risk factors for delayed bleeding after therapeutic gastrointestinal endoscopy in patients receiving oral anticoagulants: a Multicenter Retrospective Study. Digestion. 2021;102(2):161–9.