Utility of prophylactic clipping after colorectal cold snare polypectomy in patients on oral antithrombotic agents

Abstract

There is no consensus on the effectiveness of prophylactic clipping after colonic cold snare polypectomy (CSP). This study aimed to evaluate the utility of prophylactic clipping in preventing delayed bleeding (DB) after colorectal CSP in patients on antithrombotic agents. We retrospectively recruited consecutive patients on antithrombotic agents who underwent colorectal CSP in Chiba University Hospital. The DB rate was compared between patients with and without prophylactic clipping. The study included 133 patients (422 polyps) requiring prophylactic clipping and 85 patients (282 polyps) not requiring prophylactic clipping. The DB and hematochezia rates have no significant difference between both groups. By weighted logistic regression analysis, the odds ratio of hematochezia was 0.557 (95% confidence interval, 0.225-1.378; p = 0.205) in patients without clipping compared to those with clipping. Prophylactic clipping may not be necessary to prevent DB after colorectal CSP in patients on antithrombotic agents.