Postpolypectomy bleeding of colorectal polyps in patients with continuous warfarin and short-term interruption of direct oral anticoagulants
Gastrointestinal Endoscopy Oct 09, 2020
Harada H, Miyaoka Y, Yuki T, et al. - In patients receiving treatment with warfarin and direct oral anticoagulants (DOACs), researchers sought to assess postpolypectomy bleeding (PPB). In total, 12,601 polyps in 5,449 patients who had endoscopic snare resection of colorectal polyps were recruited between August 2017 and July 2019. Endoscopic snare resection was conducted in patients receiving continuous warfarin (C-warfarin) and in those who experienced one day of withdrawal (O-) of DOACs in line with the guidelines of the Japanese Gastroenterological Endoscopy Society (JGES). Significant risk factors for PPB were male gender, warfarin, DOACs, and multipolyp removal, as seen in multivariate logistic regression analysis. An independent risk factor for PPB was the use of anticoagulant therapy. The rates of PPB were also higher in patients receiving C-warfarin and O-DOACs than in patients not receiving anticoagulants. In patients undergoing endoscopic snare resection of colorectal polyps, edoxaban may be safe through short-term withdrawal.
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