Risk Factors Analysis For Delayed Post-Polypectomy Bleeding After Endoscopic Mucosal Resection

Background/objective:Endoscopic mucosal resection(EMR)is a widely used method for the removal of colorectal polyps.Although EMR is safe and effective,postoperative bleeding remains the most common complication of EMR.This study was performed to evaluate the risk of delayed hemorrhage in patients undergoing EMR and provide clinical reference for rational treatment under clinical endoscopy.Methods: January 2017-December 2020,our hospital 941 cases of colorectal polyps by endoscopic mucosal resection treatment of patients with colorectal polyps.We performed a retrospective analysis of patients with clinical data,endoscopic and pathological reports.During elective colonoscopy performed at our endoscopy center,941 patients who had polyps ≥5mm removed were correspondingly assigned to case group(hemorrhage group)that occured delayed bleeding or control group(without hemorrhage group),the clinical situation of two groups were compared to analyze the risk factors of postpolypectomy bleedind.Results:941 patients(resection of 1236 polyps)were enrolled.Delayed bleeding occurred in 28 patients(33 polyps removed),with bleeding rates of 3.0% and 2.7%,respectively.Univariate analysis results showed that the gender,polyp size,polyp shape,polyp location,intraoperative prophylactic use of hemostatic clamp,intraoperative immediate bleeding in 2 groups of patients,the difference was statistically significant(p<0.05);Multivariate binary logistic regression analysis showed that male sex(P =0.003,OR=6.615),intraoperative bleeding(P=0.001,OR=7.794)and polyps in the right colon(P =0.034,OR=0.439)were independent risk factors for delayed bleeding after EMR.Conclusion: The patient was male,the polyp was located in the right colon,as well as immediate bleeding during procedure was an independent risk factor for delayed bleeding after endoscopic mucosal resection.Careful inspection to the above risk factors during operation is necessary to the Endoscopic physicians and taking effective.measures in advance,which is conducive to reducing the risk of bleeding.