Page 67 - 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

improved to a certain extent, the number of outpatient or daytime operations has gradually increased,
and the number of inpatient operations has gradually decreased. At present, the main methods of

endoscopic resection of colorectal polyps include hot snare polypectomy (HSP), cold snare
polypectomy (CSP), endoscopic mucosal resection (EMR), endoscopic submucosal dissection
(ESD), hot biopsy (HB) and argon plasma coagulation (APC). Additionally, complications after
colorectal polypectomy are still an important problem for clinicians.

Delayed postpolypectomy bleeding (DPPB) is one of the complications that can occur after
[3].
colorectal polypectomy; it most often occurs after 24 hours, with an incidence of 0.6%~0.9%
DPPB is difficult to detect via emergency endoscopy because the bleeding location is often hidden
in the intestines covered by feces, thus increasing the burden on the doctors' diagnosis and treatment

work. Additionally, the problems caused by DPPB, such as patient discomfort, prolonged
hospitalization, increased medical costs, and even increased patient mortality, can affect the
harmony of the doctor‒patient relationship.
There are different reports in the literature on factors related to DPPB. Some studies have shown

that the incidence of DPPB is higher among patients receiving anticoagulant therapy [4-6] . Some
studies also showed that the incidence of DPPB was positively correlated with the size of polyps
removed [7-9] . A meta-analysis has concluded that cardiovascular disease, hypertension, polyps

larger than 10 mm, and polyps located in the right colon are important risk factors for delayed
bleeding [10] .However, there remains a lack of clarity regarding the use of preventive measures on
the wound surface during operation [11, 12] , and whether such factors will affect the incidence of
DPPB. Therefore, the risk factors of DPPB still need further verification. This study aims to update,

comprehensively analyze, and explore the relevant risk factors for the occurrence of DPPB, to
further optimize clinical response strategies and provide reference.
2. Methods
2.1. Literature Retrieval

Three large Chinese databases were searched: CNKI database, Wan Fang database, and Wei Pu
database. The databases were searched from inception to July 1, 2022. The key words were
polypectomy or polypectomy or bleeding after polypectomy. Four large English databases were
searched: Web of Science, PubMed, Cochrane Library, and Embase. The keywords were Polyp,

Postoperative Hemorrhages, Risk Factors, and their free words. There were no language restrictions.
The combination of subject words, keywords, and free words was used to search the databases and
merge the search results.

2.2. Inclusion criteria and exclusion criteria
The inclusion criteria were as follows: (1) prospective cohort study or retrospective case‒control
study; (2) an independent study with complete data and more than one control group with the same
research purpose; (3) the study sample was adult patients (≥18 years old); and (4) the content of the
study was the risk factors for delayed bleeding after colorectal polypectomy.

The exclusion criteria were as follows: (1) the research content did not involve or was not related to

- 63 -