Trial reportGastroenterology2019
Clip Closure After Resection of Large Colorectal Lesions With Substantial Risk of Bleeding.
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 69 papers, 3 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.
Clip Closure of Mucosal Defects After Endoscopic Mucosal Resection of Large Colorectal Lesions as Prophylaxis of Delayed Haemorrhage.
Tranexamic Acid to Prevent Bleeding After Endoscopic Resection of Large Colorectal Polyps: A Pilot Project
Who cites it
69 citing papers in PubMed, 3 syntheses or guidelines pooled it, 157 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
- 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
- Trial
- Trial
- Trial
- Continuous suture technique increases the complete closure rate of colorectal mucosal defects after endoscopic resection: a single-blind, randomized controlled trial.Surgical endoscopy · 2023Trial
- Outcomes for Underwater Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection of 21-30-mm Colorectal Polyps: A Feasible Study.Digestive diseases and sciences · 2023Trial
- Clinical usefulness of the hold-and-drag closure using the SB clip for large mucosal defects after colorectal endoscopic submucosal dissection.Surgical endoscopy · 2023Trial
- 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
- Divergent Efficacy of Prophylactic Clipping: Gaps Between Expert Centers and Real‑World Practice.Digestive diseases and sciences · 2026Article
- Review
- Prediction and Prevention of Delayed Post-polypectomy-induced Ulcer Hemorrhage Based Upon an Anatomic Study and Multivariable Analyses.Digestive diseases and sciences · 2026Article
- Traction Device-Assisted Complete Closure to Prevent Colorectal Post-ESD Coagulation Syndrome.Digestive diseases and sciences · 2026Article
- Effect of Prophylactic Colon ESD (Endoscopic Submucosal Dissection) Defect Closure on Post-ESD Outcomes: An International Multi-center Retrospective Study.Digestive diseases and sciences · 2026Article
- Through-the-scope twin clip for endoscopic closure of gastrointestinal defects: efficacy, safety, and factors influencing closure speed.Surgical endoscopy · 2026Observational
- High Rates of Defect Closure After Resection of Large Nonpedunculated Colorectal Lesions Using a Through-The-Scope Clip With Anchor Prongs.United European gastroenterology journal · 2026Observational
- Prevention of Delayed Bleeding after Endoscopic Resection using Gel Hemostatic Powder: A Multicentric Open-lapel Prospective Study.Endoscopy international open · 2026Article
- A novel polysaccharide hemostatic agent in prevention of post-procedural bleeding following large colonic polyp resection.Endoscopy international open · 2026Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Commented on byReply.2020
Authors and funding
20 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsIt is not clear whether closure of mucosal defects with clips after colonic endoscopic mucosal resection (EMR) prevents delayed bleeding, although it seems to have no protective effects when risk is low. We performed a randomized trial to evaluate the efficacy of complete clip closure of large (≥2 cm) nonpedunculated colorectal lesions after EMR in patients with an estimated average or high risk of delayed bleeding.
methodsWe performed a single-blind trial at 11 hospitals in Spain from May 2016 through June 2018, including 235 consecutive patients who underwent EMR for large nonpedunculated colorectal lesions with an average or high risk of delayed bleeding (based on Spanish Endoscopy Society Endoscopic Resection Group score). Participants were randomly assigned to groups that received closure of the scar with 11-mm through-the-scope clips (treated, n = 119) or no clip (control, n = 116). The primary outcome was proportion of patients in each group with delayed bleeding, defined as evident hematochezia that required medical intervention within 15 days after colonoscopy.
resultsIn the clip group, complete closure was achieved in 68 (57%) cases, with partial closure in 33 (28%) cases and failure to close in 18 (15%) cases. Delayed bleeding occurred in 14 (12.1%) patients in the control group and in 6 (5%) patients in the clip group (absolute risk difference, reduction of 7% in the clip group; 95% confidence interval, -14.7% to 0.3%). After completion of the clip closure, there was only 1 (1.5%) case of delayed bleeding (absolute risk difference, reduction of 10.6%; 95% confidence interval, -4.3% to 17.9%).
conclusionsIn a randomized trial of patients with large nonpedunculated colorectal lesions undergoing EMR, we found that clip closure of mucosal defects in patients with a risk of bleeding can be a challenge, but also reduces delayed bleeding. Prevention of delayed bleeding required complete clip closure. ClinicalTrials.gov ID: NCT02765022.
Indexed as
Identifiers
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.