None listed
Conditions
Interventions
Procedure/Surgery : If a sessile polyp with a diameter of 10mm to 15mm is detected, the polyp is removed using either cold endosscopic mucosal resection (Cold-EMR) or hot endoscopic mucosal resection
Sponsors
Soon Chun Hyang University Hospital Seoul
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patients aged 19 and above, with a history of anticoagulant medication use within the last 30 days, who have a sessile polyp measuring 10mm or more but less than 15mm (10-15mm) in size detected during colonoscopy and are being considered for endoscopic resection.
Exclusion criteria
Exclusion criteria: ? Patients who are unable to discontinue anticoagulant therapy based on recent guidelines and have a high risk of thromboembolic events. ? Patients who have been taking warfarin within the last 30 days. ? Cases where complete resection through endoscopic polypectomy is expected to be difficult due to endoscopic findings (visual appearance, Kudo pit pattern, Japan Narrow-Band Imaging Expert Team (JNET) classification of Type 2B or higher) indicating the possibility of invasive cancer (16). ? Cases where rescue treatment is required due to failed or incomplete resection attempts during endoscopic polypectomy. ? Patients with inflammatory bowel disease. ? Patients with hereditary colorectal tumors or the presence of 10 or more multiple polyps. ? Patients with known blood-related disorders such as leukemia, myelodysplastic syndromes, or hemophilia, or patients who have had a platelet count 40 seconds and/or PT INR > 1.2) within the last 3 months according to preoperative tests. ? Patients who do not consent to participate in the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Comparison of overall bleeding rates between cold snare polypectomy (Cold-EMR) and hot snare polypectomy (Hot-EMR) according to the selection criteria in patients. | — |
Secondary
| Measure | Time frame |
|---|---|
| Comparison of incidence of the following complications during or after the procedure ? Occurrence of mucosal bleeding during the procedure and implementation of hemostasis measures. ? Occurrence of acute post-procedural bleeding. ? Incidence of post-procedural coagulation syndrome. ? Occurrence of perforation after the procedure.;Comparison of en-bloc resection rates between cold snare polypectomy and hot snare polypectomy.;Analysis of risk factors associated with overall bleeding events.;Sub-analysis dividing patients into groups based on resumption of medication: those who resumed medication on the day following the procedure and those who resumed medication two days after the procedure, analyzing the frequency of delayed bleeding complications. | — |
Countries
Korea, Republic of
Contacts
Public ContactShin Ju Oh
Kyung Hee University Hospital
Outcome results
None listed