Tu1045 PERIOPERATIVE HEPARIN BRIDGING FOR COLORECTAL EMR OR ESD FOR PATIENTS RECEIVING ANTICOAGULATION RESULTED IN A VERY HIGH INCIDENCE OF BLEEDING COMPLICATION

Yoshimura, Daisuke; Ochiai, Toshiaki; Fukuda, Shinichiro; Niho, Kojiro; Kitagawa, Yusuke; Ihara, Eikichi; Ogawa, Yoshihiro

doi:10.1016/j.gie.2018.04.2105

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2020

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“…12,13 A higher risk of PPB (51.7%) was noted in patients undergoing endoscopic mucosal resection (EMR) while on heparin bridge therapy. 14 Continued warfarin use has also previously been found to have an increased risk of PPB (OR, 13.4; 95% CI, 4.1-43.7). 15 Increased costs of hospitalization have also been reported in association with heparin bridge therapy.…”

Section: Risk Factorsmentioning

confidence: 93%

Endoscopic Management of Post-Polypectomy Bleeding

Gutta

Gromski

2020

Clin Endosc

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Post-polypectomy bleeding (PPB) is one of the most common complications of endoscopic polypectomy. There are multiple risk factors related to patient and polyp characteristics that should be considered. In most cases, immediate PPB can be effectively managed endoscopically when recognized and managed promptly. Delayed PPB can manifest in a myriad of ways. In severe delayed PPB, resuscitation for hemodynamic stabilization should be prioritized, followed by endoscopic evaluation and therapy once the patient is stabilized. Future areas of research in PPB include the risks of direct oral anticoagulants and of specific electrosurgical settings for hot-snare polypectomy vs. cold-snare polypectomy, benefits of closure of post-polypectomy mucosal defects using through-the-scope clips, and prospective comparative evaluation of newer hemostasis agents such as hemostatic spray powder and over-the-scope clips.Clin Endosc 2020;53:302-310

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