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The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study

BACKGROUND: In July 2012, the Japan Gastroenterological Endoscopy Society updated their guidelines for gastroenterological endoscopy in patients receiving antithrombotic therapy. Colonoscopic polypectomy procedures are associated with a high risk of bleeding. OBJECTIVES: The present study evaluated...

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Autores principales: Bozkurt, Hilmi, Sert, Özlem Zeliha, Ölmez, Tolga, Keklikkıran, Zeynep Zehra, Uzun, Orhan, Gülmez, Selçuk, Polat, Erdal, Duman, Mustafa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação Paulista de Medicina - APM 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9625013/
https://www.ncbi.nlm.nih.gov/pubmed/33759909
http://dx.doi.org/10.1590/1516-3180.2020.0305.R1.10122020
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author Bozkurt, Hilmi
Sert, Özlem Zeliha
Ölmez, Tolga
Keklikkıran, Zeynep Zehra
Uzun, Orhan
Gülmez, Selçuk
Polat, Erdal
Duman, Mustafa
author_facet Bozkurt, Hilmi
Sert, Özlem Zeliha
Ölmez, Tolga
Keklikkıran, Zeynep Zehra
Uzun, Orhan
Gülmez, Selçuk
Polat, Erdal
Duman, Mustafa
author_sort Bozkurt, Hilmi
collection PubMed
description BACKGROUND: In July 2012, the Japan Gastroenterological Endoscopy Society updated their guidelines for gastroenterological endoscopy in patients receiving antithrombotic therapy. Colonoscopic polypectomy procedures are associated with a high risk of bleeding. OBJECTIVES: The present study evaluated the safety of colonoscopic polypectomy procedures in terms of bleeding, among patients receiving antithrombotic therapy. DESIGN AND SETTING: Prospective observational study conducted in a tertiary-level public cardiovascular hospital in Istanbul, Turkey. METHODS: Colonoscopic polypectomies carried out in a single endoscopy unit between July 2018 and July 2019 were evaluated prospectively. The patients’ data, including age, gender, comorbidities, whether antithrombotic drug use was ceased or whether patients were switched to bridging therapy, polyp size, polyp type, polyp location, histopathology, resection methods (hot snare, cold snare or forceps) and complications relating to the procedures were recorded. RESULTS: The study was completed with 94 patients who underwent a total of 167 polypectomy procedures. As per the advice of the physicians who prescribed antithrombotic medications, 108 polypectomy procedures were performed on 60 patients without discontinuing medication and 59 polypectomy procedures were performed on 34 patients after discontinuing medication. The age, gender distribution and rate of bleeding did not differ significantly between the patients whose medication was discontinued and those whose medication was continued (P > 0.05). CONCLUSION: This study found that the colonoscopic polypectomy procedure without discontinuation of antithrombotic medication did not increase the risk of bleeding. This procedure can be safely performed by experienced endoscopists in patients with an international normalized ratio (INR) below 2.5.
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spelling pubmed-96250132022-11-02 The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study Bozkurt, Hilmi Sert, Özlem Zeliha Ölmez, Tolga Keklikkıran, Zeynep Zehra Uzun, Orhan Gülmez, Selçuk Polat, Erdal Duman, Mustafa Sao Paulo Med J Original Article BACKGROUND: In July 2012, the Japan Gastroenterological Endoscopy Society updated their guidelines for gastroenterological endoscopy in patients receiving antithrombotic therapy. Colonoscopic polypectomy procedures are associated with a high risk of bleeding. OBJECTIVES: The present study evaluated the safety of colonoscopic polypectomy procedures in terms of bleeding, among patients receiving antithrombotic therapy. DESIGN AND SETTING: Prospective observational study conducted in a tertiary-level public cardiovascular hospital in Istanbul, Turkey. METHODS: Colonoscopic polypectomies carried out in a single endoscopy unit between July 2018 and July 2019 were evaluated prospectively. The patients’ data, including age, gender, comorbidities, whether antithrombotic drug use was ceased or whether patients were switched to bridging therapy, polyp size, polyp type, polyp location, histopathology, resection methods (hot snare, cold snare or forceps) and complications relating to the procedures were recorded. RESULTS: The study was completed with 94 patients who underwent a total of 167 polypectomy procedures. As per the advice of the physicians who prescribed antithrombotic medications, 108 polypectomy procedures were performed on 60 patients without discontinuing medication and 59 polypectomy procedures were performed on 34 patients after discontinuing medication. The age, gender distribution and rate of bleeding did not differ significantly between the patients whose medication was discontinued and those whose medication was continued (P > 0.05). CONCLUSION: This study found that the colonoscopic polypectomy procedure without discontinuation of antithrombotic medication did not increase the risk of bleeding. This procedure can be safely performed by experienced endoscopists in patients with an international normalized ratio (INR) below 2.5. Associação Paulista de Medicina - APM 2021-03-22 /pmc/articles/PMC9625013/ /pubmed/33759909 http://dx.doi.org/10.1590/1516-3180.2020.0305.R1.10122020 Text en © 2022 by Associação Paulista de Medicina https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons license.
spellingShingle Original Article
Bozkurt, Hilmi
Sert, Özlem Zeliha
Ölmez, Tolga
Keklikkıran, Zeynep Zehra
Uzun, Orhan
Gülmez, Selçuk
Polat, Erdal
Duman, Mustafa
The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study
title The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study
title_full The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study
title_fullStr The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study
title_full_unstemmed The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study
title_short The risk of post-polypectomy bleeding among patients receiving antithrombotic agents: A prospective observational study
title_sort risk of post-polypectomy bleeding among patients receiving antithrombotic agents: a prospective observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9625013/
https://www.ncbi.nlm.nih.gov/pubmed/33759909
http://dx.doi.org/10.1590/1516-3180.2020.0305.R1.10122020
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