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Polyps: major issues and minor details ▸

Accurate information about the risks of procedures is vital, yet quoted risks of colonoscopic polypectomy vary significantly, are often based on retrospective single centre series, and may be outdated as indications, equipment, and techniques have changed with time. The authors conducted a prospective multicentre study of 24 382 colonoscopies, in which 4070 snare polypectomies (>5 mm) were performed in 2311 patients. Detailed information on patient demographics, comorbidity, polyp configuration, and location was collected. Structured forms gathered data on immediate and late (30 day) complications, the primary end points being bleeding, perforation, or death. These were all defined as major complications, unless bleeding was dealt with fully at the time of polypectomy or needed no intervention when it was classified as a minor complication.

An impressive data collection rate of 98% was achieved and the overall rate of complications was 9.7%: bleeding accounted for 8.6% (7% minor and 1.6% major) while perforation occurred in 1.1%. Hospitalisation or prolonged inpatient stay resulted from 25% of complications (2.4% of all patients) but no mortality occurred. Not surprisingly, multivariate analysis confirmed that sessile right sided …

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