Endoscopy 2019; 51(04): S33
DOI: 10.1055/s-0039-1681267
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: Colon: resection South Hall 2B
Georg Thieme Verlag KG Stuttgart · New York

THE SAFETY OF COLD SNARE POLYPECTOMY (CSP) ON ANTITHROMBOTIC THERAPY

Y Kimoto
1   NTT Medical Center Tokyo, Tokyo, Japan
,
K Ohata
1   NTT Medical Center Tokyo, Tokyo, Japan
,
Y Minato
1   NTT Medical Center Tokyo, Tokyo, Japan
,
T Nakao
1   NTT Medical Center Tokyo, Tokyo, Japan
,
N Konishi
1   NTT Medical Center Tokyo, Tokyo, Japan
,
R Ishii
1   NTT Medical Center Tokyo, Tokyo, Japan
,
K Kanda
1   NTT Medical Center Tokyo, Tokyo, Japan
,
R Negishi
1   NTT Medical Center Tokyo, Tokyo, Japan
,
S Ogawa
1   NTT Medical Center Tokyo, Tokyo, Japan
,
M Takita
1   NTT Medical Center Tokyo, Tokyo, Japan
,
R Takeda
1   NTT Medical Center Tokyo, Tokyo, Japan
,
E Sakai
1   NTT Medical Center Tokyo, Tokyo, Japan
,
T Muramoto
1   NTT Medical Center Tokyo, Tokyo, Japan
,
T Shiga
1   NTT Medical Center Tokyo, Tokyo, Japan
,
H Tanaka
1   NTT Medical Center Tokyo, Tokyo, Japan
,
N Matsuhashi
1   NTT Medical Center Tokyo, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    Cold snare polypectomy (CSP) is a safer and more efficacious polypectomy technique without electrocautery, therefore it is widely used for the removal of small polyps (< 10 mm). Recent studies have revealed that delayed bleeding and perforation are few observed in CSP. However the safety of CSP in patients who are on antithrombotic therapy have not been fully evaluated. The aim of this study was to determine the safety of CSP in patients who are currently on antithrombotic therapy.

    Methods:

    3021 consecutive patients with colorectal polyps (< 10 mm) were removed by CSP between March 2016 and Oct 2018. We retrospectively assessed the characteristics of polyps, histological results, and delayed bleeding rates.

    Results:

    5706 polyps in 3021 patients (2266 males and 755 females) were removed by CSP. There were 1197 polyps (19.4%) in 586 patients (antiplatelets to 155, anticoagulants to 83 and both to 28 patients) in the antithrombotic group (group A) and 4509 polyps (80.6%) in 2435 patients in the non-antithrombotic group (group B). Delayed bleeding occurred in 0.51% (3/586) of patients in group A and 0.12% (3/2435) of patients in group B, showing no significant difference (p = 0.09). The patients delayed bleeding occurred in Group A included 2 aspirin users with 2 polyps and 1 aspirin plus rivaroxaban user with 2 polyps. No delayed bleeding occurred in patients on other antithrombotic agents or receiving heparin bridging. There was no significant difference between delayed bleeding rates in group A and group B. No delayed bleeding cases required transfusion and surgery. None of the followings correlated with delayed bleeding; age, gender, polyp location, size, morphology, histology, number of polyps resected.

    Conclusions:

    CSP is safety technique for removal of diminutive or small polyp even if patients receive antithrombotic therapy. And without cessation of the antithrombotic therapy, it is possible to reduce the risk of thromboembolism.


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