Page 66 - 北京京煤集团总医院第十一届·2023学术年会论文集

北京京煤集团总医院 第十一届·2023 学术年会论文集

Risk Factors for Delayed Colorectal Postpolypectomy

Bleeding: A Meta-analysis

a
c*
Xuzhen Zhang, M.M. , Xiaoxing Jiang, M.B. , Liang Shi, M.M.
b
a Department of Gastrointestinal Endoscopy Center, Beijing Jingmei Group General Hospital,
Beijing, China.
b The Second Department of Internal Medicine, Huaping Hospital of Traditional Chinese Medicine,
Lijiang City, Yunnan Province, China.
c The First Department of General Surgery, Cangzhou Central Hospital of Hebei Province,

Cangzhou, Hebei Province, China.
* Correspondence: Liang Shi, The First Department of General Surgery, Cangzhou Central Hospital
of Hebei Province, Cangzhou, Hebei Province, China.
E-mail: ascendant2019gie@126.com (L. Shi)

Running title: Risk Factors for Delayed Colorectal Postpolypectomy Bleeding
Abstract
Background: To systematically analyze risk factors for delayed postpolypectomy bleeding (DPPB)
in colorectum. Methods: We searched seven large databases from inception to July 2022 to identify

studies that investigated risk factors for DPPB. The effect sizes were expressed by relative risk (RR)
2
and 95% confidence interval (95% CI). The heterogeneity was analyzed by calculating I values and
performing sensitivity analyses. Results: A total of 15 articles involving 24,074 subjects were
included in the study. The incidence of DPPB was found to be 0.02% (95% CI, 0.01–0.03), with an

2
I value of 98%. Our analysis revealed that male sex (RR=1.41), history of hypertension (RR=1.47),
history of diabetes (RR=1.17), anticoagulation (RR=3.56), aspirin (RR=1.46) before surgery,
number of removed polyps ≥ 3 (RR=2.35), polyp size (RR=1.17), polyp size≥10mm (RR=2.13),

polyp size>10mm (RR=3.65), pedunculated polyp (RR=1.73), and polyps located in the right
semicolon (RR=2.23) were risk factors for DPPB. Conclusions: Male sex, history of hypertension,
history of antithrombotic drugs and aspirin before surgery, number of removed polyps≥3, polyp
size≥10 mm, and pedunculated polyps were the risk factors for DPPB.Based on our findings, we
recommend that endoscopists should fully consider and implement effective intervention measures

to minimize the risk of DPPB.
Trial registration: PROSPERO. Registration date:2022-11-25. Registration number:
CRD42022375804.

Keywords: Colorectal polyps; Postoperative bleeding; Risk factors; Meta-analysis
1. Background
Colonoscopy is very practical for screening and preventing colon cancer, and its importance is self-
evident . Endoscopic colorectal polypectomy has been proven to be an effective method to reduce
[1]
the mortality of colorectal cancer . With the continuous development of modern medicine and the
[2]
continuous improvement of treatment technology, the safety of colorectal polypectomy has been

- 62 -