Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case–control study

J. M. Cha; K. S. Lim; S. H. Lee; Y. E. Joo; S. P. Hong; T. I. Kim; H. G. Kim; D. I. Park; S. E. Kim; D. H. Yang; J. E. Shin

doi:10.1055/s-0032-1326104

Endoscopy, Inhaltsverzeichnis

Endoscopy 2013; 45(03): 202-207
DOI: 10.1055/s-0032-1326104

Original article

Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case–control study

J. M. Cha

¹Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea

,

K. S. Lim

¹Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea

,

S. H. Lee

²Department of Internal Medicine, Chonan Hospital, Soonchunhyang University College of Medicine, Chonan, Korea

,

Y. E. Joo

³Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea

,

S. P. Hong

⁴Department of Internal Medicine and Institute of Gastroenterology, Yonsei University Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

,

T. I. Kim

⁴Department of Internal Medicine and Institute of Gastroenterology, Yonsei University Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

,

H. G. Kim

⁵Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea

,

D. I. Park

⁶Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

,

S. E. Kim

⁷Department of Internal Medicine, Ewha Mokdong University Hospital, Ewha Womans University School of Medicine, Seoul, Korea

,

D. H. Yang

⁸Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

,

J. E. Shin

⁹Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Chonan, Korea

› Institutsangaben

Abstract

Background and study aims: Post-polypectomy coagulation syndrome (PPCS) is a well known complication of colonoscopic polypectomy. However, no previous studies have reported on the clinical outcomes or risk factors of PPCS. The aim of the current study was to analyze the clinical outcomes and risk factors of PPCS developing after a colonoscopic polypectomy.

Patients and methods: Data for all patients who underwent colonoscopic polypectomies and required hospitalization in nine university hospitals were analyzed retrospectively. The incidence, clinicopathological characteristics, and clinical outcomes of PPCS cases were examined. Additionally, patients who developed PPCS were compared with controls who were matched by age and sex, in order to assess for possible risk factors.

Results: The rate of PPCS that required hospitalization after colonoscopic polypectomy was 0.7/1000. All patients with PPCS were treated medically without the need for surgical interventions. The median durations of therapeutic fasting, hospitalization, and antibiotic use were 3 days, 5.5 days, and 7 days, respectively. The rates of major PPCS and mortality were 2.9 % and 0 %, respectively. On multivariate analysis, hypertension (OR = 3.023, 95 %CI 1.034 – 8.832), large lesion size (OR = 2.855, 95 %CI 1.027 – 7.937), and non-polypoid configuration (OR = 3.332, 95 %CI 1.029 – 10.791) were found to be independent risk factors related to the development of PPCS.

Conclusions: In this study, the rates of major PPCS and mortality were only 2.9 % and 0 %, respectively. Hypertension, large lesion size, and non-polypoid configuration of the lesion were independently associated with PPCS. Therefore, patients may be reassured by the excellent prognosis of PPCS, while endoscopists should be especially careful when performing colonoscopic polypectomies in patients with hypertension or large and non-polypoid lesions.

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Referenzen

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