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Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review

Delayed postpolypectomy bleeding (DPPB) is the most common complication of colonoscopic polypectomy. Prophylactic clipping after an uncomplicated polypectomy is increasingly used, but it is unclear if this results in the prevention of DPPB. This study aimed to review prophylactic clip use and its ef...

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Autores principales: Mangira, Dileep, Ket, Shara N, Majeed, Ammar, Gibson, Peter R, Brown, Gregor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206987/
https://www.ncbi.nlm.nih.gov/pubmed/30483572
http://dx.doi.org/10.1002/jgh3.12047
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author Mangira, Dileep
Ket, Shara N
Majeed, Ammar
Gibson, Peter R
Brown, Gregor
author_facet Mangira, Dileep
Ket, Shara N
Majeed, Ammar
Gibson, Peter R
Brown, Gregor
author_sort Mangira, Dileep
collection PubMed
description Delayed postpolypectomy bleeding (DPPB) is the most common complication of colonoscopic polypectomy. Prophylactic clipping after an uncomplicated polypectomy is increasingly used, but it is unclear if this results in the prevention of DPPB. This study aimed to review prophylactic clip use and its effect on the rates of DPPB. MEDLINE, Embase, and the Cochran Library were systematically searched for studies (1995–March 2017) that used prophylactic hemoclips and assessed DPPB as an outcome. Of 1402 articles identified, nine papers were eligible for inclusion, evaluating 4311 patients and 7783 polyps; 118 patients experienced a DPPB, and 49 of these patients received prophylactic clips. There was no significant difference in DPPB rates in patients who received prophylactic clipping compared to those who did not (odd ratio: 0.8; 95% confidence interval: 0.36–1.77; P = 0.56). There was also no significant difference in the DPPB of polyps <20 mm compared with polyps ≥20 mm. Clip application for prophylactic management of an uncomplicated polypectomy has not been demonstrated to reduce the risk of DPPB, casting doubt on the use of this costly practice.
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spelling pubmed-62069872018-11-27 Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review Mangira, Dileep Ket, Shara N Majeed, Ammar Gibson, Peter R Brown, Gregor JGH Open Review Article Delayed postpolypectomy bleeding (DPPB) is the most common complication of colonoscopic polypectomy. Prophylactic clipping after an uncomplicated polypectomy is increasingly used, but it is unclear if this results in the prevention of DPPB. This study aimed to review prophylactic clip use and its effect on the rates of DPPB. MEDLINE, Embase, and the Cochran Library were systematically searched for studies (1995–March 2017) that used prophylactic hemoclips and assessed DPPB as an outcome. Of 1402 articles identified, nine papers were eligible for inclusion, evaluating 4311 patients and 7783 polyps; 118 patients experienced a DPPB, and 49 of these patients received prophylactic clips. There was no significant difference in DPPB rates in patients who received prophylactic clipping compared to those who did not (odd ratio: 0.8; 95% confidence interval: 0.36–1.77; P = 0.56). There was also no significant difference in the DPPB of polyps <20 mm compared with polyps ≥20 mm. Clip application for prophylactic management of an uncomplicated polypectomy has not been demonstrated to reduce the risk of DPPB, casting doubt on the use of this costly practice. Wiley Publishing Asia Pty Ltd 2018-03-25 /pmc/articles/PMC6206987/ /pubmed/30483572 http://dx.doi.org/10.1002/jgh3.12047 Text en © 2018 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Article
Mangira, Dileep
Ket, Shara N
Majeed, Ammar
Gibson, Peter R
Brown, Gregor
Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review
title Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review
title_full Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review
title_fullStr Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review
title_full_unstemmed Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review
title_short Postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: A systematic review
title_sort postpolypectomy prophylactic clip closure for the prevention of delayed postpolypectomy bleeding: a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206987/
https://www.ncbi.nlm.nih.gov/pubmed/30483572
http://dx.doi.org/10.1002/jgh3.12047
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