Trial reportGastroenterology2019
Efficacy of Prophylactic Hemoclips in Prevention of Delayed Post-Polypectomy Bleeding in Patients With Large Colonic Polyps.
Trial report in Gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 41 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Risk of Post-Polypectomy Bleeding With Prophylactic Hemoclipping
AIDA: A Multicenter, Prospective, Randomized Controlled Trial to Evaluate the Clinical Efficacy and Safety of Artificial Intelligence (AI) Detection of Adenomas (AIDA) With Standard High Definition With Light in Screening Colonoscopy
Who cites it
41 citing papers in PubMed, 4 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Prophylactic Clip Closure for the Prevention of Delayed Bleeding After EMR of Proximal Large Nonpedunculated Colorectal Polyps: Updated Meta-Analysis of Randomized Controlled Trials.Digestive diseases and sciences · 2026Pooled it
- Pooled it
- Prevention of delayed post-polypectomy bleeding by prophylactic clipping after endoscopic colorectal polypectomy: a meta-analysis.International journal of colorectal disease · 2022Pooled it
- Prophylactic clipping to prevent delayed colonic post-polypectomy bleeding: meta-analysis of randomized and observational studies.Surgical endoscopy · 2022Pooled it
- Clinical Trial: Precise Administration of Sucralfate Powder in Prevention of Delayed Postpolypectomy Bleeding. A Randomized Controlled Trial.Clinical and translational gastroenterology · 2025Trial
- Prophylactic clip application for large pedunculated polyps before snare polypectomy may decrease immediate postpolypectomy bleeding.BMC gastroenterology · 2020Trial
- Efficacy of prophylactic hemoclip placement for preventing delayed post-polypectomy bleeding in nonpedunculated colorectal lesions: updated meta-analysis and trial sequential analysis of randomized controlled trials.Surgical endoscopy · 2026Review
- Cost-Effectiveness Analysis of Defect Closure Techniques After Conventional Endoscopic Mucosal Resection for Large Colon Polyps.Digestive diseases and sciences · 2026Article
- Comparative Effectiveness of a Prophylactic Application for the Prevention of Postpolypectomy Bleeding in Pedunculated Colonic Polyps: A Network Meta-Analysis.Gut and liver · 2026Article
- Prediction and Prevention of Delayed Post-polypectomy-induced Ulcer Hemorrhage Based Upon an Anatomic Study and Multivariable Analyses.Digestive diseases and sciences · 2026Article
- Prevention of Delayed Bleeding after Endoscopic Resection using Gel Hemostatic Powder: A Multicentric Open-lapel Prospective Study.Endoscopy international open · 2026Article
- Of Endpoints and Equipoise: Reforming Clinical Trials in Colorectal Polyp Resection.Current gastroenterology reports · 2025Review
- Defect closure after endoscopic submucosal dissection decreased the adverse events in patients with large rectal neoplasms: a propensity score matching analysis.Surgical endoscopy · 2025Article
- Complete closure utilizing titanium clips minimizes delayed postpolypectomy bleeding after colorectal endoscopic mucosal resection: a retrospective analysis.Therapeutic advances in gastroenterology · 2025Article
- Risk of post-polypectomy bleeding and thromboembolic events during colonoscopy in patients on continued or interrupted antiplatelet therapy: a pooled analysis.Frontiers in pharmacology · 2025Article
- Delphi consensus statement for the management of delayed post-polypectomy bleeding.Therapeutic advances in gastroenterology · 2025Article
- A dynamic online nomogram for predicts delayed postoperative bleeding after colorectal polyp surgery.Scientific reports · 2024Article
- Periprocedural Anticoagulation Management of Patients Undergoing Colonoscopy with Polypectomy.TH open : companion journal to thrombosis and haemostasis · 2024Article
- Outline of Japanese Guidelines for Colorectal Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection with a Short Reference to the Western Recommendations.Journal of the anus, rectum and colon · 2024Review
- Colorectal Post-polypectomy Bleeding in Outpatient versus Inpatient Treatment: Propensity Score Matching Analysis.Journal of the anus, rectum and colon · 2024Article
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsThe efficacy of prophylactic placement of hemoclips to prevent delayed bleeding after removal of large colonic polyps has not been established. We conducted a randomized equivalence study to determine whether prophylactic placement of hemoclips affects incidence of delayed post-polypectomy bleeding (PPB).
methodsDuring elective colonoscopy performed at 4 Veterans Affairs Medical Centers, 1098 patients who had polyps ≥1 cm removed were randomly assigned to groups that received prophylactic hemoclips (n = 547) or no hemoclips (n = 551), from September 2011 through September 2018. Data on PPB (rectal bleeding resulting in hemoglobin decreases ≥2 g/dL, hemodynamic instability, colonoscopy, angiography, or surgery) within 30 days of colonoscopy (called delayed PPB) were collected during telephone interviews or hospital visits 7 and 30 days after colonoscopy. The primary outcome was the incidence of important post-polypectomy bleeding.
resultsTwelve patients in the hemoclip group (2.3%) and 15 patients in the no hemoclip group (2.9%) had important delayed PPB. There were no deaths, and no patients in either group required angiography or surgery. In intention-to-treat analysis, two 1-sided test's lower and upper confidence interval limits were -2.07 and 1.01, indicating that the data approached but did not meet equivalence criteria. On multiple logistic regression analysis, significant predictors of PPB included use of warfarin with bridging, thienopyridines, polyp size, and polyp location, but hemoclip placement did not associate with important delayed PPB.
conclusionsIn a randomized trial, we found that prophylactic placement of hemoclips after removal of large colon polyps does not affect the proportion of important delayed PPB events, compared with no hemoclip placement. These findings call into question the widespread, expensive practice of routinely placing prophylactic hemoclips after polypectomy. ClinicalTrials.gov ID: NCT01647581.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.