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The goal of this retrospective cohort study is to evaluate the risk of post-polypectomy bleeding following the colonoscopy resection of lower gastrointestinal polyps in patients with liver cirrhosis with portal hypertension. The main question it aims to answer is:
Does the risk of bleeding increase after colonoscopy polypectomy in patients with liver cirrhosis with portal hypertension?
Participants will be subjected to polypectomy of any colonic polyps.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Liver cirrhosis patients with portal hypertension and colonic polyps | Colonic polypectomy |
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| Measure | Description | Time Frame |
|---|---|---|
| Immediate post polypectomy bleeding (IPPB) | During procedure | |
| Delayed post polypectomy bleeding (DPPB) | 24 hours to 14 days |
| Measure | Description | Time Frame |
|---|---|---|
| Type of polyps in patients with liver cirrhosis and portal hypertension | Using the Paris classification system for polyps | 14 days |
| Measure | Description | Time Frame |
|---|---|---|
| Prediction of risk of post polypectomy bleeding | Using the updated Endoscopic Resection Group of the Spanish Society of Endoscopy model and the Australian Colonic Endoscopic Resection model | 6 months |
Inclusion Criteria:
Exclusion Criteria:
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Liver cirrhosis patients with evidence of portal hypertension
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| Name | Affiliation | Role |
|---|---|---|
| Ayman Sadek, MD | Zagazig University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zagazig University Hospital | Zagazig | Sharqia Province | 44519 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25048486 | Result | Lee S, Park SJ, Cheon JH, Kim TI, Kim WH, Kang DR, Hong SP. Child-Pugh score is an independent risk factor for immediate bleeding after colonoscopic polypectomy in liver cirrhosis. Yonsei Med J. 2014 Sep;55(5):1281-8. doi: 10.3349/ymj.2014.55.5.1281. | |
| 23512212 | Result | Amarapurkar AD, Amarapurkar D, Choksi M, Bhatt N, Amarapurkar P. Portal hypertensive polyps: distinct entity. Indian J Gastroenterol. 2013 May;32(3):195-9. doi: 10.1007/s12664-013-0324-3. Epub 2013 Mar 20. |
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| ID | Term |
|---|---|
| D008103 | Liver Cirrhosis |
| D003111 | Colonic Polyps |
| D006975 | Hypertension, Portal |
| ID | Term |
|---|---|
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
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| 22648106 | Result | Jeon JW, Shin HP, Lee JI, Joo KR, Pack KM, Cha JM, Park JJ, Lim JU, Lim K. The risk of postpolypectomy bleeding during colonoscopy in patients with early liver cirrhosis. Surg Endosc. 2012 Nov;26(11):3258-63. doi: 10.1007/s00464-012-2334-0. Epub 2012 May 31. |
| 14722546 | Result | Hui AJ, Wong RM, Ching JY, Hung LC, Chung SC, Sung JJ. Risk of colonoscopic polypectomy bleeding with anticoagulants and antiplatelet agents: analysis of 1657 cases. Gastrointest Endosc. 2004 Jan;59(1):44-8. doi: 10.1016/s0016-5107(03)02307-1. |
| 8674375 | Result | Gibbs DH, Opelka FG, Beck DE, Hicks TC, Timmcke AE, Gathright JB Jr. Postpolypectomy colonic hemorrhage. Dis Colon Rectum. 1996 Jul;39(7):806-10. doi: 10.1007/BF02054448. |
| 8253009 | Result | Rosen L, Bub DS, Reed JF 3rd, Nastasee SA. Hemorrhage following colonoscopic polypectomy. Dis Colon Rectum. 1993 Dec;36(12):1126-31. doi: 10.1007/BF02052261. |
| 20601131 | Result | Giannini EG, Greco A, Marenco S, Andorno E, Valente U, Savarino V. Incidence of bleeding following invasive procedures in patients with thrombocytopenia and advanced liver disease. Clin Gastroenterol Hepatol. 2010 Oct;8(10):899-902; quiz e109. doi: 10.1016/j.cgh.2010.06.018. Epub 2010 Jun 30. |
| 27677683 | Result | Cocero N, Bezzi M, Martini S, Carossa S. Oral Surgical Treatment of Patients With Chronic Liver Disease: Assessments of Bleeding and Its Relationship With Thrombocytopenia and Blood Coagulation Parameters. J Oral Maxillofac Surg. 2017 Jan;75(1):28-34. doi: 10.1016/j.joms.2016.08.033. Epub 2016 Sep 2. |
| 26203733 | Result | Tripodi A. Hemostasis abnormalities in cirrhosis. Curr Opin Hematol. 2015 Sep;22(5):406-12. doi: 10.1097/MOH.0000000000000164. |
| 25536646 | Result | Mucino-Bermejo J, Carrillo-Esper R, Mendez-Sanchez N, Uribe M. Thrombosis and hemorrhage in the critically ill cirrhotic patients: five years retrospective prevalence study. Ann Hepatol. 2015 Jan-Feb;14(1):93-8. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D007417 | Intestinal Polyps |
| D011127 | Polyps |
| D020763 | Pathological Conditions, Anatomical |