Safety and efficacy of cold snare polypectomy for pedunculated (Ip) polyps measuring less than 10 mm in diameter

Arimoto, Jun; Chiba, Hideyuki; Ashikari, Keiichi; Fukui, Ryo; Tachikawa, Jun; Suto, Takuma; Kawano, Naoya; Niikura, Toshihiro; Kuwabara, Hiromichi; Nakaoka, Michiko; Ida, Tomonori; Higurashi, Takuma; Goto, Tetsuhiro; Nakajima, Atsushi

doi:10.1007/s00384-020-03547-5

Cited by 13 publications

(26 citation statements)

References 28 publications

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“…Detailed information about the excluded studies is presented in the supporting information. Eventually, 30 articles were included 24–53 …”

Section: Resultsmentioning

confidence: 99%

“…For warfarin, 22 studies mentioned HB before the procedures 24,25,27,29,31–37,39–42,45,46,48–50,52,53 . One study focused on the cold polypectomy‐continued DOACs and warfarin during procedures 30 . The detailed information about the strategies of DOACs and warfarin are presented in the supporting information.…”

Section: Resultsmentioning

confidence: 99%

“…No study selected the community population as the control group. Fourteen studies did not report the non‐response rate 25,28–30,34,38,39,41,42,44,49–52 . The detailed information about each item of NOS is provided in the supporting information.…”

Section: Resultsmentioning

confidence: 99%

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Bleeding after endoscopic resection between direct oral anticoagulants or warfarin: Systematic review and meta‐analysis

Zhu

Tao

et al. 2021

J of Gastro and Hepatol

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Background and Aim Oral anticoagulants are risk factors for post‐endoscopic resection bleeding. We aimed to conduct a systematic review and meta‐analysis for the risks of post‐procedural bleeding (PPB) for direct oral anticoagulants (DOACs) and warfarin following endoscopic resection. Methods Two independent reviewers searched PubMed, Web of Science, Embase, and Cochrane Library. The Newcastle–Ottawa Scale score was used to assess the quality of the studies, the pooled odds ratio (OR) to present PPB results, and the funnel plots to assess publication bias. The Higgins I2 statistic was employed to determine the variation across studies due to heterogeneity. Results We reviewed 30 articles. PPB occurred in 586 patients on DOACs and 1782 on warfarin. The patients on DOACs had a significantly lower overall risk of PPB compared with those on warfarin (OR, 0.867, 95% confidence interval, 0.771–0.975; P = 0.017, I2 = 1.6%). Cumulative meta‐analysis showed that the PPB rate of DOACs has the trend to be lower than that of warfarin with publication year and sample size. For the subgroup of endoscopic submucosal dissection, the PPB of DOACs was significantly lower than that of warfarin (OR, 0.786; 95% confidence interval, 0.633–0.976; P = 0.029, I2 = 0%). No significant difference was observed between DOACs and warfarin for anticoagulant strategies, endoscopic procedures, and lesion location. Conclusions Compared with warfarin, DOACs have the possibility to significantly decrease the risk of PPB following endoscopic resection, especially for endoscopic submucosal dissection.

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“…Detailed information about the excluded studies is presented in the supporting information. Eventually, 30 articles were included 24–53 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Bleeding after endoscopic resection between direct oral anticoagulants or warfarin: Systematic review and meta‐analysis

Zhu

Tao

et al. 2021

J of Gastro and Hepatol

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“…Several factors, including age, 10 , 19 use of hemoclipping, 13 , 19 , 22 and characteristics of polyps such as size, 10 , 13 , 14 , 16 , 17 , 19 , 24 polypoid morphology, 14 , 17 , 24 and rectal location, 14 , 17 were associated with immediate or delayed bleeding rates after CSP in the included studies. However, meta-analyses could be performed for only prophylactic clipping and polyp size.…”

Section: Resultsmentioning

confidence: 96%

“…Eight prospective studies (including five randomized controlled trials) and nine retrospective studies were analyzed. Most studies were conducted in East Asia, 3 , 7 , 11 – 17 , 19 , 20 , 23 – 25 and the remaining studies were conducted in Italy, 10 the United States, 22 and Australia/New Zealand. 18 …”

Section: Resultsmentioning

confidence: 99%

Safety of cold snare polypectomy with periprocedural antithrombotic agents for colorectal polyps: a systematic review and meta-analysis

Wang

Lin

Lee

et al. 2022

Therap Adv Gastroenterol

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Background: We aimed to study the safety of cold snare polypectomy (CSP) for colorectal polyps in patients administered periprocedural antithrombotic agents. Methods: We searched the PubMed, Embase, and Cochrane Library databases through June 2021. The primary outcomes were the rates of delayed and immediate bleeding (requiring endoscopic hemostasis). Secondary outcomes included thromboembolic events. Meta-analysis using odds ratios (ORs) and corresponding 95% confidence intervals (CIs) was performed to compare the outcomes. Results: Seventeen studies, including five randomized trials, were included. Over 96% of polyps were ⩽1 cm. The pooled rates of delayed and immediate bleeding for patients receiving CSP and periprocedural antithrombotic agents were 1.6% and 10.5%, respectively. Both the delayed (OR = 4.02, 95% CI = 1.98–8.17) and immediate bleeding (OR = 5.85, 95% CI = 3.84–8.89) rates were significantly higher in patients using periprocedural antithrombotic agents than in non-users. Although both antiplatelet agents and anticoagulants increased the risk of delayed bleeding, the risks associated with the use of direct oral anticoagulants (DOACs; 2.5%) or multiple agents (3.9%) were particularly high. Compared to their counterparts, diminutive polyps and uncomplicated lesions not requiring hemoclipping were associated with lower risks of delayed bleeding (pooled estimates of 0.4% and 0.18%, respectively). Thromboembolic risk was similar among patients using and not using periprocedural antithrombotic agents. Conclusions: CSP with periprocedural antiplatelet agents and warfarin may be feasible, especially for diminutive polyps. However, drug discontinuation should be considered with the use of DOACs or multiple agents which entail higher bleeding risk even with hemoclipping.

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Adoption of Optimal Small (6–9 mm) Colorectal Polyp Resection Technique Over Time

et al. 2022

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Safety and efficacy of cold snare polypectomy for pedunculated (Ip) polyps measuring less than 10 mm in diameter

Cited by 13 publications

References 28 publications

Bleeding after endoscopic resection between direct oral anticoagulants or warfarin: Systematic review and meta‐analysis

Bleeding after endoscopic resection between direct oral anticoagulants or warfarin: Systematic review and meta‐analysis

Safety of cold snare polypectomy with periprocedural antithrombotic agents for colorectal polyps: a systematic review and meta-analysis

Adoption of Optimal Small (6–9 mm) Colorectal Polyp Resection Technique Over Time

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