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Gastroenterology Research and Practice
Volume 2014, Article ID 825179, 5 pages
http://dx.doi.org/10.1155/2014/825179
Clinical Study

Optimal Timing for Resuming Antithrombotic Agents and Risk Factors for Delayed Bleeding after Endoscopic Resection of Colorectal Tumors

Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan

Received 6 August 2014; Revised 11 November 2014; Accepted 11 November 2014; Published 7 December 2014

Academic Editor: Antoni Castells

Copyright © 2014 Kazuko Beppu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To examine optimal timing for resuming antithrombotic agents and risk factors for delayed bleeding after endoscopic resection of colorectal tumors. Method. Of 1,970 polyps larger than 10 mm removed by polypectomy, endoscopic mucosal resection, or endoscopic submucosal dissection, delayed bleeding, which was designated as bleeding that occurred 6 or more hours after endoscopic treatment, occurred in 52 cases (2.6%); 156 nonbleeding cases matched for age and gender were controls in this single-institution retrospective case-control study. We investigated (1) patient-factors: resuming antithrombotic agents within 5 days following endoscopic resection, hypertension, and diabetes mellitus; and (2) tumor-factors: morphology, size, location, and resection technique by conditional logistic regression. Results. By multivariate analysis resumption of anticoagulants within 5 days was a significant risk factor for delayed bleeding (OR 10.2; 95% CI = 2.7–38.3; ). But resuming a thienopyridine within 5 days was not (OR 0.9; 95% CI = 0.1–2.6; ). Other patient- and tumor-factors were not significant. Conclusion. Resuming anticoagulants within 5 days after endoscopic treatment was associated with delayed bleeding whereas resuming thienopyridines was not.