ArticleJournal of the Canadian Association of Gastroenterology2019
Routine Prophylactic Endoscopic Clipping Is Not Efficacious in the Prevention of Delayed Post-Polypectomy Bleeding: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Article in Journal of the Canadian Association of Gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04559880 (Tranexamic Acid to Prevent Bleeding After Endoscopic Resection of Large Colorectal Polyps), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Tranexamic Acid to Prevent Bleeding After Endoscopic Resection of Large Colorectal Polyps: A Pilot Project
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Prophylactic clipping to prevent delayed colonic post-polypectomy bleeding: meta-analysis of randomized and observational studies.Surgical endoscopy · 2022Pooled it
- 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
- Prediction and Prevention of Delayed Post-polypectomy-induced Ulcer Hemorrhage Based Upon an Anatomic Study and Multivariable Analyses.Digestive diseases and sciences · 2026Article
- Standardized Selective Clipping for Persistent Immediate Bleeding after Cold Snare Polypectomy of Small Colorectal Polyps: A Prospective Cohort Study.Endoscopy international open · 2026Article
- Post-polypectomy colorectal bleeding: current strategies and the way forward.Clinical endoscopy · 2025Review
- Technical Advances in Endoscopic Resection Techniques for Lower GI Malignancies.Visceral medicine · 2024Review
- [Risk factors for delayed bleeding after intestinal polypectomy in children].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Article
- Effect of Instruction on Preventing Delayed Bleeding after Colorectal Polypectomy and Endoscopic Mucosal Resection.Journal of clinical medicine · 2021Article
- Delayed Bleeding After Endoscopic Resection of Colorectal Polyps: Identifying High-Risk Patients.Clinical and experimental gastroenterology · 2021Review
- Prophylactic hemoclips in prevention of delayed post-polypectomy bleeding for ≥ 1 cm colorectal polyps: meta-analysis of randomized controlled trials.Endoscopy international open · 2020Review
- Prevention of delayed post-polypectomy bleeding: Should we amend the 2017 ESGE Guideline?Endoscopy international open · 2020Article
- Endoscopic Management of Post-Polypectomy Bleeding.Clinical endoscopy · 2020Review
- Prophylactic Endoscopic Clipping Does Not Prevent Delayed Postpolypectomy Bleeding in Routine Clinical Practice: A Propensity Score-Matched Cohort Study.The American journal of gastroenterology · 2020Article
- Practice patterns and predictors of prophylactic endoscopic clip usage during polypectomy.Endoscopy international open · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsColorectal cancer (CRC) can be prevented through colonoscopic polypectomy, but this exposes patients to risks, including delayed post-polypectomy bleeding (DPPB). Endoscopists increasingly use clips prophylactically with the aim of preventing DPPB. However, clips are costly, and data to support their efficacy in this context are inconsistent. We performed a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of prophylactic clipping for preventing DPPB.
methodsWe searched electronic databases and other relevant sources for randomized controlled trials assessing the efficacy of prophylactic clipping versus no clipping for the prevention of DPPB. Pooled relative risks were determined using a fixed-effects model. Subgroup analyses were also performed.
resultsA total of 2305 citations were initially screened. Seven randomized controlled trials satisfied all criteria for inclusion. The quality of included studies was generally low to moderate. A total of 2851 patients underwent 5405 polypectomies. Delayed post-polypectomy bleeding occurred at an overall pooled rate of 2.5%. No overall benefit of clipping for preventing DPPB was observed, with a pooled relative risk of 0.86 (95% confidence interval [CI], 0.55 to 1.36). No significant patient or polyp factors predicting DPPB were found through subgroup analyses. No publication bias was identified.
conclusionsRandomized trials to date do not demonstrate a protective effect of prophylactic clipping for the prevention of DPPB, and therefore, the practice of routine prophylactic clipping appears unjustified. Additional high quality randomized trials are required to identify higher-risk groups that may benefit from prophylactic clipping.
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What OpenQuestion holds
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.