Nonaka Emi, Horiuchi Ichitaro, Horiuchi Akira, Ukai Satoshi, Takahata Noriko, Oishi Kimihiko
Department of Pediatrics The Jikei University School of Medicine Tokyo Japan.
Digestive Disease Center Showa Inan General Hospital Nagano Prefecture Japan.
DEN Open. 2025 Jul 17;6(1):e70175. doi: 10.1002/deo2.70175. eCollection 2026 Apr.
We prospectively investigated the risk of colonoscopy-related bleeding in relation to antithrombotic treatment.
This prospective, observational, single-center cohort study (NCT02594813) enrolled consecutive patients who underwent colonoscopy, including the removal of colorectal polyps, regardless of the continuation of antithrombotic treatment. The primary outcome measure was delayed bleeding in the patients who underwent a hot snare polypectomy and/or endoscopic mucosal resection in addition to a cold snare polypectomy (CSP) and required endoscopic treatment ≤2 weeks after the procedure. Secondary outcomes were immediate bleeding and the number of hemostatic clips used during the procedure.
From January 2019 to December 2023 at our institution, 1562 (mean age 75 years) and 15,769 (mean age, 64 years) patients underwent colonoscopy with or without antithrombotic treatment, respectively. Immediate bleeding following the removal of colorectal polyps, regardless of the polypectomy technique, occurred in 173 (33.86%) of the 511 patients with antithrombotic treatment, which was significantly more frequent than in 439 (9.44%) of the 4651 patients without antithrombotic treatment ( < 0.001). On the other hand, there was no significant difference in delayed bleeding after CSP between the two groups (0.41% vs. 0.11%, = 0.15). However, the incidence of delayed bleeding following polypectomy was significantly higher in patients receiving antithrombotic treatment compared to those without it (seven of 511 [1.37%] vs. 12 of 4651 [0.26%], = 0.0016).
The risk of delayed bleeding after colonoscopy with removal of colorectal polyps was low despite continuation of antithrombotic therapy. www.clinicaltrials.gov (NCT02594813).
我们前瞻性地研究了与抗血栓治疗相关的结肠镜检查后出血风险。
这项前瞻性、观察性、单中心队列研究（NCT02594813）纳入了连续接受结肠镜检查的患者，包括切除大肠息肉，无论抗血栓治疗是否持续。主要结局指标是除冷圈套息肉切除术（CSP）外还接受热圈套息肉切除术和/或内镜黏膜切除术且术后≤2周需要内镜治疗的患者的延迟出血。次要结局是即时出血以及手术过程中使用的止血夹数量。
2019年1月至2023年12月在我们机构，分别有1562例（平均年龄75岁）和15769例（平均年龄64岁）患者接受了有无抗血栓治疗的结肠镜检查。无论息肉切除技术如何，511例接受抗血栓治疗的患者中有173例（33.86%）在切除大肠息肉后出现即时出血，这明显比4651例未接受抗血栓治疗的患者中的439例（9.44%）更频繁（<0.001）。另一方面，两组在CSP后延迟出血方面无显著差异（0.41%对0.11%，P = 0.15）。然而，接受抗血栓治疗的患者息肉切除术后延迟出血的发生率显著高于未接受抗血栓治疗的患者（511例中的7例[1.37%]对4651例中的12例[0.26%]，P = 0.0016）。
尽管继续进行抗血栓治疗，但切除大肠息肉的结肠镜检查后延迟出血的风险较低。www.clinicaltrials.gov（NCT02594813）。
