Liu Changqin, Wu Ruijin, Sun Xiaomin, Tao Chunhua, Liu Zhanju
Department of Gastroenterology and Hepatology Shanghai Tenth People's Hospital of TongJi University Shanghai China.
JGH Open. 2018 Nov 9;3(1):61-64. doi: 10.1002/jgh3.12106. eCollection 2019 Feb.
Delayed postpolypectomy hemorrhage is relatively common, with occasional extensive blood loss, endangering life. This study aimed to determine the factors associated with postoperative hemorrhage.
The study was a retrospective cohort study of patients hospitalized for colonoscopic polypectomy at the Department of Gastroenterology and Hepatology, Tenth People's Hospital of Tongji University, China, between January and December 2015. Data on gender, age, bowel preparation, location, size, number of polyps, operative modality, pathology, and operation practitioner were collected. Patients were divided into two groups based on the presence or absence of postoperative hemorrhage.
A total of 1962 polyps were detected in patients and they underwent polypectomy; hemorrhage occurred in 41 cases. A correlation was demonstrated between postpolypectomy hemorrhage and each of the following factors: polyp size and operative modality. The odds ratio (OR) was 4.535 (95% confidence interval [CI], 2.331-8.823) for 1-2-cm polyps, 4.008 (95% CI, 0.904-17.776) for 2-3-cm polyps, and 22.407 (95% CI, 5.783-86.812) for ≥3-cm polyps. Compared with argon plasma coagulation, OR was 9.128 (95% CI, 3.548-23.486) for endoscopic mucosal resection and 31.257 (95% CI, 7.009-139.395) for endoscopic submucosal dissection.
The independent risk factors for delayed postpolypectomy hemorrhage include polyp size and operative modality.
息肉切除术后延迟出血相对常见，偶尔会出现大量失血，危及生命。本研究旨在确定与术后出血相关的因素。
本研究是一项回顾性队列研究，研究对象为2015年1月至12月在中国同济大学附属第十人民医院胃肠肝病科因结肠镜息肉切除术住院的患者。收集了患者的性别、年龄、肠道准备情况、息肉位置、大小、数量、手术方式、病理及手术操作者等数据。根据术后是否出血将患者分为两组。
患者共检测出1962枚息肉并接受了息肉切除术；41例发生出血。息肉切除术后出血与以下各因素之间存在相关性：息肉大小和手术方式。1 - 2厘米息肉的比值比（OR）为4.535（95%置信区间[CI]，2.331 - 8.823），2 - 3厘米息肉的OR为4.008（95% CI，0.904 - 17.776），≥3厘米息肉的OR为22.407（95% CI，5.783 - 86.812）。与氩离子凝固术相比，内镜黏膜切除术的OR为9.128（95% CI，3.548 - 23.486），内镜黏膜下剥离术的OR为31.257（95% CI，7.009 - 139.395）。
息肉切除术后延迟出血的独立危险因素包括息肉大小和手术方式。
