Endoscopy 2014; 46(12): 1123
DOI: 10.1055/s-0034-1378102
Letters to the editor
© Georg Thieme Verlag KG Stuttgart · New York

Further studies are needed on the prevention of postpolypectomy bleeding in pedunculated colonic polyps

Limei Ma
,
Zhining Fan
Further Information

Publication History

Publication Date:
27 November 2014 (online)

We read with great interest the article by Ji et al., in which the authors compared the efficacy of prophylactic clip and endoloop application for the prevention of postpolypectomy bleeding in large pedunculated colonic polyps. The authors concluded that the clip was as effective and safe as the endoloop. We would like to make the following comments.

First, in Table 4, the stalk diameter should be ≤ 10 mm and not ≤ 1.0 mm as shown.[*] Second, a total of 17 endoscopists participated in the study. Our concern is that the participation of so many endoscopists might influence the outcome. Finally, we know that anticoagulant or antiplatelet therapy can increase the risk of bleeding. In the article, nine patients experienced immediate bleeding, three of whom were taking anticoagulant or antiplatelet therapy prior to colonoscopy. It would be useful to have more information about the anticoagulant or antiplatelet therapy of the two groups of patients.

Well-designed studies are still required to compare a prophylactic clip with endoloop application for the prevention of postpolypectomy bleeding in pedunculated colonic polyps. The cost-effectiveness of the two devices also requires investigation.

 
  • References

  • 1 Ji JS, Lee SW, Kim TH et al. Comparison of prophylactic clip and endoloop application for the prevention of postpolypectomy bleeding in pedunculated colonic polyps: a prospective, randomized, multicenter study. Endoscopy 2014; 46: 598-604