Abstract
Introduction: Antithrombotic agents are one of major risk factors for delayed hemorrhage after colonic EMR. Whereas the patients without antithrombotic therapy can be performed colonic EMR relatively safe, there are several risks to receive colonic EMR. The aim of present study was to evaluate the risk factors of the delayed hemorrhage after colonic EMR in patients without antithrombotic therapy. Methods: The present study included 995 patients with colonic EMR from January 2013 to December 2016 in Saga Medical Centre Koseikan. The patients who received antithrombotic therapy were excluded from the study. The risk factors were evaluated regarding the patient-characteristics, the lesion-characteristics, and prevented hemoclips. Delayed hemorrhage was defined that the emergency endoscopic hemostasis was applied for bleeding more than 24 h after the EMR procedure. Results: Totally, 2,034 polyps of 995 patients were evaluated in the present study. The average of age was 68.0 years old and the average polyp size was 7.6 mm. Delayed hemorrhage occurred in 14 patients (1.4%). Multivariate analysis indicated that delayed hemorrhage occurred more frequently in the young patients (age <70 years old, P<0.01), and in the large polyp (size >10mm, P=0.01). Prevented hemoclips were applied for the 284 patients (28.5%), and the clips were not statistically effective for delayed bleeding. Conclusion: The present pilot retrospective chart review suggested that the relatively young age (age <70 years old) and the relatively large polyps (size >10 mm) might be risks for the patients without antithrombotic therapy, which warrant a further clinical trial with multicenter study in Japan.
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