Clips for the prevention and treatment of postpolypectomy bleeding (hemoclips in polypectomy).

Abstract

The most accurate method for the prevention and treatment of complications after polypectomy has not been well defined. The prophylactic use of hemoclips may reduce the risk of bleeding, mainly in pedunculated big polyps. To evaluate the accuracy of hemoclips in the prophylaxis and treatment of bleeding after endoscopic polypectomy. Retrospective study of 223 consecutive endoscopic polypectomies performed in our Endoscopy Unit between january and october 2001. Hemoclips were routinely used only for large polyps (15 to 40 mm); all of them were located in the colon except one, a gastric polyp. From a total of 223 polypectomies (215 patients), hemoclips were used for 34 (15.2%), in 30 of them just before and in 4 just after polypectomy. When used prophylactically no complication was observed, except one mild bleeding episode (3.3%) that stopped with the placing of a second hemoclip. The therapeutic clipping (4 polypectomies) induced immediate haemostasis in all cases. The prophylactic use of hemoclips is associated with a very low risk of bleeding after endoscopic resection of big polyps. Therapeutic clipping is an effective measure for polypectomy-related bleeding.