Publication: Efficacy of submucosal epinephrine injection for the prevention of postpolypectomy bleeding: A meta-analysis of randomized controlled studies
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0
Issued Date
2017
Resource Type
File Type
application/pdf
ISSN
20490801
Other identifier(s)
2-s2.0-85020922920
Rights Holder(s)
Scopus
Bibliographic Citation
Annals of Medicine and Surgery. Vol 19, (2017), p.65-73
Suggested Citation
Tullavardhana T., Akranurakkul P., Ungkitphaiboon W., Songtish D. Efficacy of submucosal epinephrine injection for the prevention of postpolypectomy bleeding: A meta-analysis of randomized controlled studies. Annals of Medicine and Surgery. Vol 19, (2017), p.65-73. doi:10.1016/j.amsu.2017.05.035 Retrieved from: https://hdl.handle.net/20.500.14740/4134
Abstract
Background Bleeding is the most common major complication following colonoscopic polypectomy. The purpose of this study is to evaluate whether submucosal epinephrine injections could prevent the occurrence of postpolypectomy bleeding. Method The dataset was defined by searching PubMed, EMBASE, Google Scholar, and the Cochrane database for appropriate randomized controlled studies published before April 2015. A meta-analysis was conducted to investigate the preventative effect of submucosal epinephrine injection for overall, early, and delayed postpolypectomy bleeding. Results The final analysis examined the findings of six studies, with data from 1388 patients. The results demonstrated that prophylactic treatment with epinephrine injection significantly reduced the occurrence of overall (OR = 0.38, 95% CI: 0.21, 0.66; p = 0.0006) and early bleeding (OR = 0.38, 95% CI: 0.20, 0.69; p = 0.002). However, for delayed bleeding complications, epinephrine injections were not found to be any more effective than treatment with saline injection or no injection (OR = 0.45, 95% CI: 0.11, 1.81; p = 0.26). Moreover, for patients with polyps larger than 20 mm, mechanical hemostasis devices (endoloops or clips) were found to be more effective than epinephrine injection in preventing overall bleeding (OR = 0.33, 95% CI: 0.13, 0.87; p = 0.03) and early bleeding (OR = 0.29, 95% CI: 0.08, 1.02; p = 0.05). This was not established for delayed bleeding. Conclusion The routine use of prophylaxis submucosal epinephrine injection is safe and beneficial preventing postpolypectomy bleeding. © 2017 The Author(s)
Subject(s)
Epinephrine
Sodium chloride
Cancer prevention
Colorectal polyp
Drug efficacy
Endoscopic polypectomy
Hemostasis
Human
Linear regression analysis
Meta analysis
Postoperative hemorrhage
Priority journal
Publishing
Randomized controlled trial (topic)
Review
Risk factor
Submucosal drug administration
Tumor volume
Sodium chloride
Cancer prevention
Colorectal polyp
Drug efficacy
Endoscopic polypectomy
Hemostasis
Human
Linear regression analysis
Meta analysis
Postoperative hemorrhage
Priority journal
Publishing
Randomized controlled trial (topic)
Review
Risk factor
Submucosal drug administration
Tumor volume