Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy: A prospective randomized, multicenter study

Suck Ho Lee, Il Kwun Chung, Sun Joo Kim, Jin Oh Kim, Bong Min Ko, Won Ho Kim, Hyun Soo Kim, Dong Il Park, Hyo Jong Kim, Jeong Sik Byeon, Suk Kyun Yang, Byeong Ik Jang, Sung Ae Jung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song

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Abstract

Aim: To evaluate and compare the clinical outcomes of prophylactic submucosal saline-epinephrine injection and saline injection alone for large colon polyps by conventional polypectomy. Methods: A prospective study was conducted from July 2003 to July 2004 at 11 tertiary endoscopic centers. Large colon polyps (> 10 mm in diameter) were randomized to undergo endoscopic polypectomy with submucosal saline-epinephrine injection (epinephrine group) or normal saline injection (saline group). Endoscopic polypectomy was performed by the conventional snare method, and early (< 12 h) and late bleeding complications (12 h-30 d) were observed. Results: A total of 561 polyps in 486 patients were resected by endoscopic polypectomy. Overall, bleeding complications occurred in 7.6% (37/486) of the patients, including 4.9% (12/244) in the epinephrine group, and 10.3% (25/242) in the saline group. Early and late postpolypectomy bleeding (PPB) occurred in 6.6% (32/486) and 1% (5/486) of the patients, respectively, including 4.5% (11/244), 0.4% (1/244) in the epinephrine group, and 8.7% (21/242), 1.7% (4/242) in the saline group. No significant differences in the rates of overall, early and late PPB were observed between the 2 groups. Multivariate stepwise logistic regression analysis revealed that large size (> 2 cm) and neoplastic polyps were independently and significantly associated with the presence of PPB. Conclusion: The prophylactic submucosal injection of diluted epinephrine does not appear to provide an additional advantage over the saline injection alone for the prevention of PPB.

Original languageEnglish
Pages (from-to)2973-2977
Number of pages5
JournalWorld Journal of Gastroenterology
Volume13
Issue number21
DOIs
Publication statusPublished - 2007 Jun 7

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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    Lee, S. H., Chung, I. K., Kim, S. J., Kim, J. O., Ko, B. M., Kim, W. H., Kim, H. S., Park, D. I., Kim, H. J., Byeon, J. S., Yang, S. K., Jang, B. I., Jung, S. A., Jeen, Y. T., Choi, J. H., Choi, H., Han, D. S., & Song, J. S. (2007). Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy: A prospective randomized, multicenter study. World Journal of Gastroenterology, 13(21), 2973-2977. https://doi.org/10.3748/wjg.v13.i21.2973