Practice Patterns, Predictors of Use and Clinical Efficacy of Endoscopic Clips for Prevention of Delayed Post-polypectomy Bleeding
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2017-12-12
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Abstract
Colonoscopy reduces colorectal cancer through the removal of pre-cancerous polyps, which exposes patients to potential adverse events. Endoscopic clips are used by practitioners to prevent delayed post-polypectomy bleeding. This thesis reports the results of two studies performed with the aim of evaluating the practice patterns and clinical efficacy of prophylactic clipping during polypectomy. A meta-analysis of randomized trials showed that prophylactic clipping is not efficacious in preventing delayed bleeding during routine polypectomy, especially among polyps < 10 mm. A large retrospective cohort study then described clinical parameters associated with clip usage. We demonstrated that use of clips increased over time in a high-volume outpatient endoscopy unit. Furthermore, a high degree of variability in clipping patterns existed between endoscopists, including among polyps < 10 mm, where no efficacy exists. Taken together, these results reveal an urgent need for effective knowledge translation to eliminate this ineffective and costly practice during routine polypectomy.
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Forbes, N. (2017). Practice Patterns, Predictors of Use and Clinical Efficacy of Endoscopic Clips for Prevention of Delayed Post-polypectomy Bleeding (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.