Clip retention rates and rates of residual polyp at the base of retained clips on colorectal EMR sites

Prasanna L. Ponugoti, Douglas Rex

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Aims Prophylactic endoscopic clipping may be effective in preventing delayed post-polypectomy hemorrhage after EMR of large colorectal lesions. The rate of retention of hemoclips on EMR sites has not been fully described. The aim of this study was to evaluate the adherence rates of hemoclips placed after EMR of large colorectal lesions. Methods This was a retrospective review of a prospectively maintained database of large colorectal polyps (≥20 mm) referred to Indiana University Hospital between June 2006 and August 2015. Sites were closed with a mean of 4 clips. Patients were followed up for 3 to 6 months after EMR with a second follow-up 1 year later. Biopsy specimens of EMR scars were examined at follow-up, including the tissue at the base of retained clips. Results There were 479 EMR sites in 424 patients that had first follow-up at our center with high-quality photographs of the EMR sites taken immediately after clip placement and at follow-up. Of 1407 Boston Scientific Resolution clips placed, 59 (4.2%) were retained at follow-up. Of 532 Cook Instinct clips placed, 46 (8.6%) were retained at first follow-up (P =.0001). There was no difference in the follow-up interval for the 2 clips. No patient had residual polyp by biopsy at the base of a retained clip. Conclusions Clip retention at first follow-up at 3 to 6 months after EMR was twice as high for the Cook Instinct clip compared with Boston Resolution clip but retention rates were low for both clips. Residual polyp at the base of retained clips was not a significant clinical problem.

Original languageEnglish (US)
Pages (from-to)530-534
Number of pages5
JournalGastrointestinal Endoscopy
Volume85
Issue number3
DOIs
StatePublished - Mar 1 2017

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Polyps
Surgical Instruments
Instinct
Biopsy
Cicatrix
Databases
Hemorrhage

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Clip retention rates and rates of residual polyp at the base of retained clips on colorectal EMR sites. / Ponugoti, Prasanna L.; Rex, Douglas.

In: Gastrointestinal Endoscopy, Vol. 85, No. 3, 01.03.2017, p. 530-534.

Research output: Contribution to journalArticle

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abstract = "Background and Aims Prophylactic endoscopic clipping may be effective in preventing delayed post-polypectomy hemorrhage after EMR of large colorectal lesions. The rate of retention of hemoclips on EMR sites has not been fully described. The aim of this study was to evaluate the adherence rates of hemoclips placed after EMR of large colorectal lesions. Methods This was a retrospective review of a prospectively maintained database of large colorectal polyps (≥20 mm) referred to Indiana University Hospital between June 2006 and August 2015. Sites were closed with a mean of 4 clips. Patients were followed up for 3 to 6 months after EMR with a second follow-up 1 year later. Biopsy specimens of EMR scars were examined at follow-up, including the tissue at the base of retained clips. Results There were 479 EMR sites in 424 patients that had first follow-up at our center with high-quality photographs of the EMR sites taken immediately after clip placement and at follow-up. Of 1407 Boston Scientific Resolution clips placed, 59 (4.2{\%}) were retained at follow-up. Of 532 Cook Instinct clips placed, 46 (8.6{\%}) were retained at first follow-up (P =.0001). There was no difference in the follow-up interval for the 2 clips. No patient had residual polyp by biopsy at the base of a retained clip. Conclusions Clip retention at first follow-up at 3 to 6 months after EMR was twice as high for the Cook Instinct clip compared with Boston Resolution clip but retention rates were low for both clips. Residual polyp at the base of retained clips was not a significant clinical problem.",
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