Early and delayed complications of polypectomy in a community setting: The SPoC prospective multicentre trial

被引:18
作者
Amato, Arnaldo [1 ]
Radaelli, Franco [1 ]
Dinelli, Marco [2 ]
Crosta, Cristiano [3 ]
Cengia, Gianpaolo [4 ]
Beretta, Paolo [5 ]
Devani, Massimo [6 ]
Lochis, Davide [7 ]
Manes, Giampiero [8 ]
Fini, Lucia [9 ]
Paggi, Silvia [1 ]
Passoni, Giovanni Rubis [10 ]
Repici, Alessandro [11 ]
机构
[1] Valduce Hosp, Dept Gastroenterol, Como, Italy
[2] San Gerardo Hosp, Gastroenterol & Endoscopy Unit, Monza, Italy
[3] European Inst Oncol, Div Endoscopy, Milan, Italy
[4] Univ Brescia, Dept Surg, Spedali Civili, Brescia, Italy
[5] Citta Studi Clin Inst, Endoscopy Serv, Milan, Italy
[6] Rho Hosp, Dept Gastroenterol, AO Salvini, Rome, Italy
[7] Policlin Monza, Endoscopy Unit, Monza, Italy
[8] Garbagnate Hosp, Dept Gastroenterol, AO Salvini, Milan, Italy
[9] AO Circolo, Dept Internal Med, Busto Arsizio, Italy
[10] San Carlo Hosp, Dept Gastroenterol, Milan, Italy
[11] Humanitas Univ, Humanitas Res Hosp, Milan, Italy
关键词
Colonoscopic polypectomy; Polypectomy complications; RISK-FACTORS; COLORECTAL-CANCER; COLONOSCOPIC POLYPECTOMY; PROPHYLACTIC CLIP; THERAPEUTIC COLONOSCOPY; PREVENTION; POLYPS; SNARE; POPULATION; HEMORRHAGE;
D O I
10.1016/j.dld.2015.09.007
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Colonoscopic polypectomy is effective in reducing the incidence of and mortality from colorectal cancer, but is not complication-free. Aims: To evaluate the incidence of early and delayed polypectomy complications and factors associated with their occurrence in a community setting. Methods: Web-database collection of patients' and polyp's features in consecutive colonic polypectomies during a 3-month period in 18 endoscopy centres. Results: Data on 5178 polypectomies in 2692 patients (54.3% males, mean age 59 years) were collected. The majority of the polyps were <10 mm (83.5%). Antithrombotic agents were taken by 22.7% of patients, 57.3% of which withheld them before the procedure. Overall, 5 patients experienced perforations (0.2%) and 114 had bleeding (4.2%); the overall complication rate was 4.4%. Early complications were observed in 87 (3.2%); delayed complications (all major bleedings) occurred in 32 (1.2%). At multivariate analysis polyp size (size > 10 mm: OR 4.35, 95% CI 5.53-7.48) and, inversely, right-sided location (OR 0.58, 95% CI 0.36-0.94) were correlated with bleeding events. The use of antithrombotics was associated with 5-fold increased risk of delayed bleeding. Conclusions: In the community setting, polypectomy was associated with a 1.4% risk of major complications. Polyp size and, inversely, right-sided location were associated with early bleeding; the use of antithrombotics increased the risk of delayed events. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:43 / 48
页数:6
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