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

Research output: Contribution to journalArticle

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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
Publication statusPublished - 2007 Jun 7

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Polyps
Epinephrine
Multicenter Studies
Colon
Hemorrhage
Injections
Prospective Studies

Keywords

  • Bleeding
  • Colonoscopic polypectomy
  • Epinephrine
  • Saline
  • Submucosal injection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy : A prospective randomized, multicenter study. / Lee, Suck Ho; Chung, Il Kwun; Kim, Sun Joo; Kim, Jin Oh; Ko, Bong Min; Kim, Won Ho; Kim, Hyun Soo; Park, Dong Il; Kim, Hyo Jong; Byeon, Jeong Sik; Yang, Suk Kyun; Jang, Byeong Ik; Jung, Sung Ae; Jeen, Yoon Tae; Choi, Jai Hyun; Choi, Hwang; Han, Dong Soo; Song, Jae Suk.

In: World Journal of Gastroenterology, Vol. 13, No. 21, 07.06.2007, p. 2973-2977.

Research output: Contribution to journalArticle

Lee, SH, Chung, IK, Kim, SJ, Kim, JO, Ko, BM, Kim, WH, Kim, HS, Park, DI, Kim, HJ, Byeon, JS, Yang, SK, Jang, BI, Jung, SA, Jeen, YT, Choi, JH, Choi, H, Han, DS & Song, JS 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, vol. 13, no. 21, pp. 2973-2977.
Lee, Suck Ho ; Chung, Il Kwun ; Kim, Sun Joo ; Kim, Jin Oh ; Ko, Bong Min ; Kim, Won Ho ; Kim, Hyun Soo ; Park, Dong Il ; Kim, Hyo Jong ; Byeon, Jeong Sik ; Yang, Suk Kyun ; Jang, Byeong Ik ; Jung, Sung Ae ; Jeen, Yoon Tae ; Choi, Jai Hyun ; Choi, Hwang ; Han, Dong Soo ; Song, Jae Suk. / Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy : A prospective randomized, multicenter study. In: World Journal of Gastroenterology. 2007 ; Vol. 13, No. 21. pp. 2973-2977.
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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.",
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T1 - Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy

T2 - A prospective randomized, multicenter study

AU - Lee, Suck Ho

AU - Chung, Il Kwun

AU - Kim, Sun Joo

AU - Kim, Jin Oh

AU - Ko, Bong Min

AU - Kim, Won Ho

AU - Kim, Hyun Soo

AU - Park, Dong Il

AU - Kim, Hyo Jong

AU - Byeon, Jeong Sik

AU - Yang, Suk Kyun

AU - Jang, Byeong Ik

AU - Jung, Sung Ae

AU - Jeen, Yoon Tae

AU - Choi, Jai Hyun

AU - Choi, Hwang

AU - Han, Dong Soo

AU - Song, Jae Suk

PY - 2007/6/7

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N2 - 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.

AB - 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.

KW - Bleeding

KW - Colonoscopic polypectomy

KW - Epinephrine

KW - Saline

KW - Submucosal injection

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