Abstract
Postprocedure bleeding remains the most common adverse event associated with endoscopic mucosal resection (EMR) of large polyps. 1 Burgess et al. Clin Gastroenterol Hepatol. 2014; 12: 651-661 Abstract Full Text Full Text PDF PubMed Scopus (141) Google Scholar Sequential placement of multiple endoclips can be used to completely close the postresection defect after endoscopic removal of a large colon polyp. Recently, 3 multicenter randomized controlled trials found that prophylactic clip closure reduces the risk of postprocedure bleeding after endoscopic resection of large colon polyps ≥20 mm in diameter. 2 Pohl H. et al. Gastroenterology. 2019; 157: 977-984 Abstract Full Text Full Text PDF PubMed Google Scholar , 3 Feagins et al. Gastroenterology. 2019; 157: 967-976 Abstract Full Text Full Text PDF PubMed Google Scholar , 4 Albéniz E. et al. Gastroenterology. 2019; 157: 1213-1221 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar Although the clinical benefit of prophylactic clip closure in this setting is becoming more clear, deploying several endoclips often remains cost prohibitive to implement in routine practice because endoclips are not presently reimbursed by payers.
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