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Management of Complications After Endoscopic Polypectomy

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Colon Polypectomy

Abstract

Polypectomy is associated with complications such as bleeding, perforation, and post-polypectomy coagulation syndrome. Moreover, nearly 30% of patients experience gastrointestinal symptoms including abdominal pain, diarrhea, bloating, and nausea that usually resolve within 24–48 h.

As for post-polypectomy bleeding and perforation, various databases report an 11-fold and threefold increased risk as compared to diagnostic colonoscopy; hence proper management of these common complications should be part of the background knowledge of every endoscopist.

The aim of this chapter is to provide the reader with all the available evidences on the management of the most common post-polypectomy complications.

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References

  1. Rutter MD, Nickerson C, Rees CJ, et al. Risk factors for adverse events related to polypectomy in the English bowel cancer screening programme. Endoscopy. 2014;46:90–7.

    Article  PubMed  Google Scholar 

  2. Ferlitsch M, Moss A, Hassan C, Bhandari P, Dumonceau JM, Paspatis G, Jover R, Langner C, Bronzwaer M, Nalankilli K, Fockens P, Hazzan R, Gralnek IM, Gschwantler M, Waldmann E, Jeschek P, Penz D, Heresbach D, Moons L, Lemmers A, Paraskeva K, Pohl J, Ponchon T, Regula J, Repici A, Rutter MD, Burgess NG, Bourke MJ. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy Clinical Guideline. Endoscopy. 2017;49(3):270–97.

    Article  PubMed  Google Scholar 

  3. Wexner SD, Garbus JE, Singh JJ, SAGES Colonoscopy Study Outcomes group. A prospective analysis of 13.580 colonoscopies. Re-evaluation of credentialing guidelines. Surg Endosc. 2001;15:251–61.

    Article  CAS  PubMed  Google Scholar 

  4. Bowles CJ, Leicester R, Romaya C, Swarbrick E, Williams CB, Epstein O. A prospective study of colonoscopy practice in the UK today: are we adequately prepared for national colorectal cancer screening tomorrow? Gut. 2004;53:277–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Gibbs DH, Opelka FG, Beck DE, Hicks TC, Timmcke AE, Gathright JB Jr. Post-polypectomy colonic hemorrhage. Dis Colon Rectum. 1996;39:806–10.

    Article  CAS  PubMed  Google Scholar 

  6. Di Giorgio P, De Luca L, Calcagno G, Rivellini G, Mandato M, De Luca B. Detachable snare versus epinephrine injection in the prevention of post-polypectomy bleeding: a randomized and controlled study. Endoscopy. 2004;36(10):860–3.

    Article  PubMed  Google Scholar 

  7. Choung BS, Kim SH, Ahn DS, Kwon DH, Koh KH, Sohn JY, Park WS, Kim IH, Lee SO, Lee ST, Kim SW. Incidence and risk factors of delayed post-polypectomy bleeding: a retrospective cohort study. J Clin Gastroenterol. 2014;48:784–9.

    Article  PubMed  Google Scholar 

  8. Repici A, Hassan C, Vitetta E, Ferrara E, Manes G, Gullotti G, Princiotta A, Dulbecco P, Gaffuri N, Bettoni E, Pagano N, Rando G, Strangio G, Carlino A, Romeo F, de Paula Pessoa Ferreira D, Zullo A, Ridola L, Malesci A. Safety of cold polypectomy for <10mm polyps at colonoscopy: a prospective multicenter study. Endoscopy. 2012;44:27–31.

    Article  CAS  PubMed  Google Scholar 

  9. Gimeno-Garcia AZ, de Ganzo ZA, Sosa AJ, Pérez DN, Quintero E. Incidence and predictors of post-polypectomy bleeding in colorectal polyps larger than 10 mm. Eur J Gastroenterol Hepatol. 2012;24:520–6.

    Article  PubMed  Google Scholar 

  10. Burgess NG, Metz AJ, Williams SJ, Singh R, Tam W, Hourigan LF, Zanati SA, Brown GJ, Sonson R, Bourke MJ. Risk factors for intra-procedural and clinically significant delayed bleeding after wide-field endoscopic mucosal resection of large colonic lesions. Clin Gastroenterol Hepatol. 2014;12:651–61.

    Article  PubMed  Google Scholar 

  11. Heresbach D, Kornhauser R, Seyrig JA, Coumaros D, Claviere C, Bury A, Cottereau J, Canard JM, Chaussade S, Baudet A, Casteur A, Duval O, Ponchon T, OMEGA group. A national survey of endoscopic mucosal resection for superficial gastrointestinal neoplasia. Endoscopy. 2010;42:806–13.

    Article  CAS  PubMed  Google Scholar 

  12. Cipolletta L, Rotondano G, Bianco MA, Buffoli F, Gizzi G, Tessari F, Italian Colorectal Endoscopic Resection (ICER) Study Group. Endoscopic resection for superficial colorectal neoplasia in Italy: a prospective multicenter study. Dig Liver Dis. 2014;46:146–51.

    Article  PubMed  Google Scholar 

  13. Repici A, Hassan C, De Paula Pessoa D, Pagano N, Arezzo A, Zullo A, Lorenzetti R, Marmo R. Efficacy and safety of endoscopic submucosal dissection for colorectal neoplasia: a systematic review. Endoscopy. 2012;44:137–50.

    Article  CAS  PubMed  Google Scholar 

  14. Fujiya M, Tanaka K, Dokoshi T, Tominaga M, Ueno N, Inaba Y, Ito T, Moriichi K, Kohgo Y. Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection. Gastrointest Endosc. 2015;81(3):583e95.

    Article  Google Scholar 

  15. Sawhney MS, Salfiti N, Nelson DB, Lederle FA, Bond JH. Risk factors for severe delayed post-polypectomy bleeding. Endoscopy. 2008;40:115–9.

    Article  CAS  PubMed  Google Scholar 

  16. Kim JH, Lee HJ, Ahn JW, Cheung DY, Kim JI, Park SH, Kim JK. Risk factors for delayed post-polypectomy hemorrhage: a case-control study. J Gastroenterol Hepatol. 2013;28:645–9.

    Article  PubMed  Google Scholar 

  17. Watabe H, Yamaji Y, Okamoto M, Kondo S, Ohta M, Ikenoue T, Kato J, Togo G, Matsumura M, Yoshida H, Kawabe T, Omata M. Risk assessment for delayed hemorrhagic complication of colonic polypectomy: polyp-related factors and patient related factors. Gastrointest Endosc. 2006;64:73–8.

    Article  PubMed  Google Scholar 

  18. Buddingh KT, Herngreen T, Haringsma J, van der Zwet WC, Vleggaar FP, Breumelhof R, Ter Borg F. Location in the right hemi-colon is an independent risk factor for delayed post-polypectomy hemorrhage: a multi-center case-control study. Am J Gastroenterol. 2011;106:1119–24.

    Article  PubMed  Google Scholar 

  19. Amato A, Radaelli F, Dinelli M, Crosta C, Cengia G, Beretta P, Devani M, Lochis D, Manes G, Fini L, Paggi S, Passoni GR, Repici A, SIED Lombardy group. Early and delayed complications of polypectomy in a community setting: the SPoC prospective multicentre trial. Dig Liver Dis. 2016; 48(1):43–8.

    Google Scholar 

  20. Dobrowolski S, Dobosz M, Babicki A, Głowacki J, Nałecz A. Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy. Gastrointest Endosc. 2006;63:1004–9.

    Article  PubMed  Google Scholar 

  21. Kim HS, Kim TI, Kim WH, Kim YH, Kim HJ, Yang SK, Myung SJ, Byeon JS, Lee MS, Chung IK, Jung SA, Jeen YT, Choi JH, Choi KY, Choi H, Han DS, Song JS. Risk factors for immediate post-polypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol. 2006;101:1333–41.

    Article  PubMed  Google Scholar 

  22. Zhang Q, Sl A, Zy C, Fu FH, Jiang B, Fc Z, Bai Y, Gong W. Assessment of risk factors for delayed colonic post-polypectomy hemorrhage: a study of 15553 polypectomies from 2005 to 2013. PLoS One. 2014;9(10):e108290.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kwon MJ, Kim YS, Bae SI, Park YI, Lee KJ, Min JH, Jo SY, Kim MY, Jung HJ, Jeong SY, Yoon WJ, Kim JN, Moon JS. Risk factors for delayed post-polypectomy bleeding. Intest Res. 2015;13(2):160–5.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Veitch AM, Vanbiervliet G, Gershlick AH, Boustiere C, Baglin TP, Smith LA, Radaelli F, Knight E, Gralnek IM, Hassan C, Dumonceau JM. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Endoscopy. 2016;48(4):385–402.

    Article  PubMed  Google Scholar 

  25. Shalman D, Gerson LB. Systematic review with meta-analysis: the risk of gastrointestinal hemorrhage post-polypectomy in patients receiving anti-platelet, anti-coagulant and/or thienopyridine medications. Aliment Pharmacol Ther. 2015;42:949–56.

    Article  CAS  PubMed  Google Scholar 

  26. Metz AJ, Bourke MJ, Moss A, Williams SJ, Swan MP, Byth K. Factors that predict bleeding following endoscopic mucosal resection of large colonic lesions. Endoscopy. 2011;43:506–11.

    Article  CAS  PubMed  Google Scholar 

  27. Bahin FF, Naidoo M, Williams SJ, Hourigan LF, Ormonde DG, Raftopoulos SC, Holt BA, Sonson R, Bourke MJ. Prophylactic endoscopic coagulation to prevent bleeding after wide-field endoscopic mucosal resection of large sessile colon polyps. Clin Gastroenterol Hepatol. 2015;13:724–30.

    Article  PubMed  Google Scholar 

  28. Yousfi M, Gostout CJ, Baron TH, Hernandez JL, Keate R, Fleischer DE, Sorbi D. Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin. Am J Gastroenterol. 2004;99:1785–9.

    Article  PubMed  Google Scholar 

  29. 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;59:44–8.

    Article  PubMed  Google Scholar 

  30. Gandhi S, Narula N, Mosleh W, Marshall JK, Farkouh M. Meta-analysis: colonoscopic post-polypectomy bleeding in patients on continued clopidogrel therapy. Aliment Pharmacol Ther. 2013;37(10):947–52.

    Article  CAS  PubMed  Google Scholar 

  31. ASGE Standards of Practice Committee, Acosta RD, Abraham NS, Chandrasekhara V, Chathadi KV, Early DS, Eloubeidi MA, Evans JA, Faulx AL, Fisher DA, Fonkalsrud L, Hwang JH, Khashab MA, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Shergill AK, Wang A, Cash BD, JM DW. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc. 2016;83(1):3–16.

    Article  Google Scholar 

  32. Paspatis GA, Tribonias G, Konstantinidis K, Theodoropoulou A, Vardas E, Voudoukis E, Manolaraki MM, Chainaki I, Chlouverakis G. A prospective randomized comparison of cold vs hot snare polypectomy in the occurrence of post-polypectomy bleeding in small colonic polyps. Color Dis. 2011;13(10):e345–e348. 41.

    Article  CAS  Google Scholar 

  33. Ichise Y, Horiuchi A, Nakayama Y, Tanaka N. Prospective randomized comparison of cold snare polypectomy and conventional polypectomy for small colorectal polyps. Digestion. 2011;84(1):78–81.

    Article  PubMed  Google Scholar 

  34. Horiuchi A, Nakayama Y, Kajiyama M, Tanaka N, Sano K, Graham DY. Removal of small colorectal polyps in anticoagulated patients: a prospective randomized comparison of cold snare and conventional polypectomy. Gastrointest Endosc. 2014;79(3):417–23.

    Article  PubMed  Google Scholar 

  35. Monkemuller K, Neumann H, Malfertheiner P, Fry LC. Advanced colon polypectomy. Clin Gastroenterol Hepatol. 2009;7:641–52.

    Article  PubMed  Google Scholar 

  36. Van Gossum A, Cozzoli A, Adler M, Taton G, Cremer M. Colonoscopic snare polypectomy: analysis of 1485 resections comparing two types of current. Gastrointest Endosc. 1992;38:472–5.

    Article  PubMed  Google Scholar 

  37. Klein A, Bourke MJ. Advanced polypectomy and resection techniques. Gastrointest Endosc Clin N Am. 2015;25(2):303–33.

    Article  PubMed  Google Scholar 

  38. Burgess NG, Bahin FF, Bourke MJ. Colonic polypectomy. Gastrointest Endosc. 2015;81(4):813–35.

    Article  PubMed  Google Scholar 

  39. Alcaide N, Penas-Herrero I, Sancho-del-Val L, Ruiz-Zorrilla R, Barrio J, Pérez-Miranda M. Ovesco system for treatment of post-polypectomy bleeding after failure of conventional treatment. Rev Esp Enferm Dig. 2014;106:55–8.

    Article  PubMed  Google Scholar 

  40. Singhal S, Changela K, Papafragkakis H, Anand S, Krishnaiah M, Duddempudi S. Over the scope clip: technique and expanding clinical applications. J Clin Gastroenterol. 2013;47:749–56.

    Article  PubMed  Google Scholar 

  41. Fahrtash-Bahin F, Holt BA, Jayasekeran V, Williams SJ, Sonson R, Bourke MJ. Snare tip soft coagulation achieves effective and safe endoscopic hemostasis during wide-field endoscopic resection of large colonic lesions. Gastrointest Endosc. 2013;78(1):158–63.

    Article  PubMed  Google Scholar 

  42. Parra-Blanco A, Kaminaga N, Kojima T, Endo Y, Uragami N, Okawa N, Hattori T, Takahashi H, Fujita R. Hemoclipping for post-polypectomy and post-biopsy colonic bleeding. Gastrointest Endosc. 2000;51:37–41.

    Article  CAS  PubMed  Google Scholar 

  43. Slivka A, Parsons WG, Carr-Locke DL. Endoscopic band ligation for treatment of post-polypectomy hemorrhage. Gastrointest Endosc. 1994;40(2 Pt 1):230e2.

    Google Scholar 

  44. Burgess NG, Williams SJ, Hourigan LF, Brown GJ, Zanati SA, Singh R, Tam W, Butt J, Byth K, Bourke MJ. A management algorithm based on delayed bleeding after wide-field endoscopic mucosal resection of large colonic lesions. Clin Gastroenterol Hepatol. 2014;12(9):1525e33.

    Article  Google Scholar 

  45. Terasaki M, Tanaka S, Shigita K, Asayama N, Nishiyama S, Hayashi N, Nakadoi K, Oka S, Chayama K. Risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal neoplasms. Int J Color Dis. 2014;29(7):877e82.

    Article  Google Scholar 

  46. Saito Y, Uraoka T, Yamaguchi Y, Hotta K, Sakamoto N, Ikematsu H, Fukuzawa M, Kobayashi N, Nasu J, Michida T, Yoshida S, Ikehara H, Otake Y, Nakajima T, Matsuda T, Saito D. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections. Gastrointest Endosc. 2010;72(6):1217e25.

    Article  Google Scholar 

  47. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, Repici A, Vieth M, De Ceglie A, Amato A, Berr F, Bhandari P, Bialek A, Conio M, Haringsma J, Langner C, Meisner S, Messmann H, Morino M, Neuhaus H, Piessevaux H, Rugge M, Saunders BP, Robaszkiewicz M, Seewald S, Kashin S, Dumonceau JM, Hassan C, Deprez PH. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2015;47(9):829e54.

    Google Scholar 

  48. 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. Comparison of post-polypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy: a prospective randomized, multicenter study. World J Gastroenterol. 2007;13:2973–7.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Dobrowolski S, Dobosz M, Babicki A, Dymecki D, Hać S. Prophylactic submucosal saline-adrenaline injection in colonoscopic polypectomy: prospective randomized study. Surg Endosc. 2004;18:990–3.

    Article  CAS  PubMed  Google Scholar 

  50. Facciorusso A, Di Maso M, Antonino M, Del Prete V, Panella C, Barone M, Muscatiello N. Polidocanol injection decreases the bleeding rate after colon polypectomy: a propensity score analysis. Gastrointest Endosc. 2015;82(2):350–8.

    Article  PubMed  Google Scholar 

  51. Shioji K, Suzuki Y, Kobayashi M, Nakamura A, Azumaya M, Takeuchi M, Baba Y, Honma T, Narisawa R. Prophylactic clip application does not decrease delayed bleeding after colonoscopic polypectomy. Gastrointest Endosc. 2003;57:691–4.

    Article  PubMed  Google Scholar 

  52. Liaquat H, Rohn E, Rex DK. Prophylactic clip closure reduced the risk of delayed post-polypectomy hemorrhage: experience in 277 clipped large sessile or flat colorectal lesions and 247 control lesions. Gastrointest Endosc. 2013;77:401–7.

    Article  PubMed  Google Scholar 

  53. Li LY, Liu QS, Li L, Cao YJ, Yuan Q, Liang SW, Qu CM. A meta-analysis and systematic review of prophylactic endoscopic treatments for post-polypectomy bleeding. Int J Color Dis. 2011;26:709–19.

    Article  CAS  Google Scholar 

  54. Lee CK, Lee SH, Park JY, Lee TH, Chung IK, Park SH, Kim HS, Kim SJ. Prophylactic argon plasma coagulation ablation does not decrease delayed post-polypectomy bleeding. Gastrointest Endosc. 2009;70:353–61.

    Article  PubMed  Google Scholar 

  55. Park CH, Jung YS, Nam E, Eun CS, Park DI, Han DS. Comparison of efficacy of prophylactic endoscopic therapies for postpolypectomy bleeding in the colorectum: a systematic review and network meta-analysis. Am J Gastroenterol. 2016;111(9):1230–43. Li lylee ck

    Article  PubMed  Google Scholar 

  56. Sethi A, Song LM. Adverse events related to colonic endoscopic mucosal resection and polypectomy. Gastrointest Endosc Clin N Am. 2015;25(1):55–69.

    Article  PubMed  Google Scholar 

  57. Thirumurthi S, Raju GS. Management of polypectomy complications. Gastrointest Endosc Clin N Am. 2015;25(2):335–57.

    Article  PubMed  Google Scholar 

  58. Levy I, Gralnek IM. Complications of diagnostic colonoscopy, upper endoscopy, and enteroscopy. Best Pract Res Clin Gastroenterol. 2016;30(5):705–18.

    Article  PubMed  Google Scholar 

  59. Ma MX, Bourke MJ. Complications of endoscopic polypectomy, endoscopic mucosal resection and endoscopic submucosal dissection in the colon. Best Pract Res Clin Gastroenterol. 2016;30(5):749–67.

    Article  PubMed  Google Scholar 

  60. Broeders E, Al-Taher M, Peeters K, Bouvy N. Verres needle desufflation as an effective treatment option for colonic perforation after colonoscopy. Surg Laparosc Endosc Percutan Tech. 2015;25(2):e61–4.

    Article  PubMed  Google Scholar 

  61. Tutticci N, Bourke MJ. Advanced endoscopic resection in the colon: recent innovations, current limitations and future directions. Expert Rev Gastroenterol Hepatol. 2014;8(2):161–77.

    Article  CAS  PubMed  Google Scholar 

  62. Wada Y, Kudo SE, Tanaka S, Saito Y, Iishii H, Ikematsu H, Igarashi M, Saitoh Y, Inoue Y, Kobayashi K, Hisabe T, Tsuruta O, Kashida H, Ishikawa H, Sugihara K. Predictive factors for complications in endoscopic resection of large colorectal lesions: a multicenter prospective study. Surg Endosc. 2015;29(5):1216–22.

    Article  PubMed  Google Scholar 

  63. Kim ES, Cho KB, Park KS, Lee KI, Jang BK, Chung WJ, Hwang JS. Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors. Endoscopy. 2011;43:573–8.

    Article  CAS  PubMed  Google Scholar 

  64. Iqbal CW, Cullinane DC, Schiller HJ, Sawyer MD, Zietlow SP, Farley DR. Surgical management and outcomes of 165 colonoscopic perforations from a single institution. Arch Surg. 2008;143:701–6.

    Article  PubMed  Google Scholar 

  65. Raju GS. Gastrointestinal perforations: role of endoscopic closure. Curr Opin Gastroenterol. 2011;27:418–22.

    Article  PubMed  Google Scholar 

  66. Oka S, Tanaka S, Kanao H, et al. Current status in the occurrence of postoperative bleeding, perforation and residual/local recurrence during colonoscopic treatment in Japan. Dig Endosc. 2010;22:376–80.

    Article  PubMed  Google Scholar 

  67. Raju GS, Saito Y, Matsuda T, Kaltenbach T, Soetikno R. Endoscopic management of colonoscopic perforations (with videos). Gastrointest Endosc. 2011;74:1380–8.

    Article  PubMed  Google Scholar 

  68. Bielawska B, Day AG, Lieberman DA, Hookey LC. Risk factors for early colonoscopic perforation include non-gastroenterologist endoscopists: a multivariable analysis. Clin Gastroenterol Hepatol. 2014;12:85–92.

    Article  PubMed  Google Scholar 

  69. Buchner AM, Guarner-Argente C, Ginsberg GG. Outcomes of EMR of defiant colorectal lesions directed to an endoscopy referral center. Gastrointest Endosc. 2012;76:255–63.

    Article  PubMed  Google Scholar 

  70. Seo EH, Kim TO, Park MJ, Joo HR, Heo NY, Park J, Park SH, Yang SY, Moon YS. Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study. Gastrointest Endosc. 2012;75(3):583–90.

    Article  PubMed  Google Scholar 

  71. Pissas D, Ypsilantis E, Papagrigoriadis S, Hayee B, Haji A. Endoscopic management of iatrogenic perforations during endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for colorectal polyps: a case series. Therap Adv Gastroenterol. 2015;8(4):176–81.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Rex DK. Water filling and carbon dioxide insufflation: tools for every colonoscopist. Clin Gastroenterol Hepatol. 2015;13(11):1981–3.

    Article  PubMed  Google Scholar 

  73. ASGE Technology Committee, Maple JT, Abu Dayyeh BK, Chauhan SS, Hwang JH, Komanduri S, Manfredi M, Konda V, Murad FM, Siddiqui UD, Banerjee S. Endoscopic submucosal dissection. Gastrointest Endosc. 2015;81(6):1311–25.

    Article  Google Scholar 

  74. Holt BA, Jayasekeran V, Sonson R, Bourke MJ. Topical submucosal chromoendoscopy defines the level of resection in colonic EMR and may improve procedural safety (with video). Gastrointest Endosc. 2013;77:949–53.

    Article  PubMed  Google Scholar 

  75. Swan MP, Bourke MJ, Moss A, Williams SJ, Hopper A, Metz A. The target sign: an endoscopic marker for the resection of the muscularis propria and potential perforation during colonic endoscopic mucosal resection. Gastrointest Endosc. 2011;73:79–85.

    Article  PubMed  Google Scholar 

  76. Tang SJ. Zipper clip closure of colonoscopic perforations. Gastrointest Endosc. 2017;85(4):867–9.

    Article  PubMed  Google Scholar 

  77. Kobara H, Mori H, Fujihara S, Nishiyama N, Chiyo T, Yamada T, Fujiwara M, Okano K, Suzuki Y, Murota M, Ikeda Y, Oryu M, Abo Ellail M, Masaki T. Outcomes of gastrointestinal defect closure with an over-the-scope clip system in a multicenter experience: an analysis of a successful suction method. World J Gastroenterol. 2017;23(9):1645–56.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Honegger C, Valli PV, Wiegand N, Bauerfeind P, Gubler C. Establishment of over-the-scope-clips (OTSC®) in daily endoscopic routine. United European Gastroenterol J. 2017;5(2):247–54.

    Article  CAS  PubMed  Google Scholar 

  79. Weiland T, Fehlker M, Gottwald T, Schurr MO. Performance of the OTSC system in the endoscopic closure of iatrogenic gastrointestinal perforations: a systematic review. Surg Endosc. 2013;27:2258–74.

    Article  PubMed  Google Scholar 

  80. Paraskeva KD, Paspatis GA. Management of bleeding and perforation after colonoscopy. Expert Rev Gastroenterol Hepatol. 2014;8(8):963–72.

    Article  CAS  PubMed  Google Scholar 

  81. Kantsevoy SV, Bitner M, Mitrakov AA, Thuluvath PJ. Endoscopic suturing closure of large mucosal defects after endoscopic submucosal dissection is technically feasible, fast, and eliminates the need for hospitalization. Gastrointest Endosc. 2014;79:503–7.

    Article  PubMed  Google Scholar 

  82. Cho SB, Lee WS, Joo YE, Kim HR, Park SW, Park CH, Kim HS, Choi SK, Rew JS. Therapeutic options for iatrogenic colon perforation: feasibility of endoscopic clip closure and predictors of the need for early surgery. Surg Endosc. 2012;26:473–9.

    Article  PubMed  Google Scholar 

  83. Kim JS, Kim BW, Kim JI, Kim JH, Kim SW, Ji JS, Lee BI, Choi H. Endoscopic clip closure versus surgery for the treatment of iatrogenic colon perforations developed during diagnostic colonoscopy: a review of 115,285 patients. Surg Endosc. 2013;27:501–4.

    Article  PubMed  Google Scholar 

  84. Jehangir A, Bennett KM, Rettew AC, Fadahunsi O, Shaikh B, Donato A. Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain. J Community Hosp Intern Med Perspect. 2015;5(5):29147.

    Article  PubMed  Google Scholar 

  85. Cha JM, Lim KS, Lee SH, Joo YE, Hong SP, Kim TI, Kim HG, Park DI, Kim SE, Yang DH, Shin JE. Clinical outcomes and risk factors of postpolypectomy coagulation syndrome: a multicenter, retrospective, case-control study. Endoscopy. 2013;45:202–7.

    Article  CAS  PubMed  Google Scholar 

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Del Prete, V., Antonino, M., Vincenzo Buccino, R., Muscatiello, N., Facciorusso, A. (2018). Management of Complications After Endoscopic Polypectomy. In: Facciorusso, A., Muscatiello, N. (eds) Colon Polypectomy. Springer, Cham. https://doi.org/10.1007/978-3-319-59457-6_8

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