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Life sciences · Journal article
Den Open · August 11, 2026
Encouraging direction, but not yet definitive.
This retrospective cohort study found that antithrombotic therapy is associated with a significantly increased risk of delayed post-polypectomy bleeding after endoscopic resection of colorectal polyps ≤15 mm, with DPPB rates of 1.91% per patient and 0.69% per lesion in the ATT group compared to 0.25% and 0.08% respectively in the non-ATT group. Despite the elevated risk, absolute bleeding rates remain low. Warfarin use carried the highest DPPB risk among ATT types.
Single-centre retrospective cohort study. Adult patients undergoing endoscopic resection of colorectal polyps ≤15 mm at Jichi Medical University Saitama Medical Center. Inclusion: polyps ≤15 mm resected between April 2021 and October 2023. Exclusion: simultaneous ESD or unavailable pathological results. Study population comprised 2136 pati…. Intervention: Endoscopic resection of colorectal polyps ≤15 mm using cold snare polypectomy (CSP), endoscopic mucosal resection (EMR), or hot snare polypectomy (HSP), selected at endoscopist discretion. Technique choice based on lesion characteristics a…. Compared with: Patients receiving antithrombotic therapy compared to those not receiving antithrombotic therapy. n = 2,136. Single centre: Jichi Medical University Saitama Medical Center, Japan.
DPPB rate per patient 1.91% (ATT group) vs. 0.25% (non-ATT group), p<0.001 DPPB rate per lesion 0.69% (ATT group) vs. 0.08% (non-ATT group), p<0.001 Univariable odds ratio for ATT use 7.84 per patient, 8.73 per lesion
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should recognize that patients receiving antithrombotic therapy face approximately 7.8-fold higher per-patient risk of DPPB, and those on warfarin warrant particular caution. However, since absolute DPPB rates remain below 2% per patient even with ATT in modern practice (without routine heparin bridging), outpatient polypectomy may remain feasible with appropriate patient selection and monitoring.
A single-centre retrospective cohort study with clear methodology and reported effect sizes showing significantly higher DPPB rates in patients on antithrombotic therapy, but limited by retrospective design and single-centre setting.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that patients receiving antithrombotic therapy face approximately 7.8-fold higher per-patient risk of DPPB, and those on warfarin warrant particular caution. However, since absolute DPPB rates remain below 2% per patient even with ATT in modern practice (without routine heparin bridging), outpatient polypectomy may remain feasible with appropriate patient selection and monitoring.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Objectives. Recent changes in the perioperative management of antithrombotic therapy (ATT), including the discontinuation of routine heparin bridging and the increased use of cold snare polypectomy, may reduce delayed post-polypectomy bleeding (DPPB) rates. However, few recent studies have evaluated these changes. We compared DPPB rates between patients with and without ATT and explored factors associated with bleeding.Methods. We conducted a retrospective cohort study of adult patients who underwent endoscopic resection of colorectal polyps ≤15 mm between April 2021 and October 2023. DPPB was defined as hematochezia or a hemoglobin drop ≥2.0 g/dL requiring endoscopic hemostasis. Univariable analyses were performed to identify factors associated with DPPB, and exploratory multivariable analyses were conducted.Results. Among 2136 patients with 7025 polyps, 523 patients (1874 polyps) were receiving ATT. The DPPB rates per patient (1.91% vs. 0.25%) and per lesion (0.69% vs. 0.08%) were significantly higher in the ATT group (p < 0.001). In univariable analyses, ATT use (odds ratio [OR] 7.84), ≥3 resected lesions (OR 5.13), and hypertension (OR 3.95) were significant risk factors in the per-patient analysis, while ATT use (OR 8.73), lesion size >10 mm (OR 4.51), and clipping (OR 5.20) were significant in the per-lesion analysis. Among ATT types, warfarin users had the highest DPPB rates.Conclusions. Colorectal polypectomy in patients receiving ATT is associated with an increased risk of DPPB. Particular caution is warranted in patients receiving warfarin.Trial registration. N/A.
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