IDDF2019-ABS-0249 Comparison of post endoscopic mucosal resection bleeding between epinephrine and hypertonic saline submucosal injection for colon polyps in patients taking antithrombotic agents. (7th June 2019) - Yamaguchi, Daisuke
Abstract : Background: The present study has investigated the comparison of the clinical outcomes of prophylactic submucosal saline-epinephrine injection and hypertonic saline injection for colon polyps in patients taking antithrombotic agents. Methods: We retrospectively investigated the medical records of 183 patients who taking antithrombotic agents among 891 patients who underwent colonic endoscopic mucosal resection (EMR) from January 2013 to March 2018. The patients were divided into two groups: group A, 92 patients with saline-epinephrine injection use; and group B, 91 patients with hypertonic saline (10%NaCl) injection use. Clinical characteristics, type of antithrombotic agents, treatment outcomes and adverse events were compared between the two groups. (figure 1 ) Results: The mean age was 73.5 and 74.0 years in group A and B, sex and patient characteristics were not different between the two groups. The main antithrombotic agents were low-dose aspirin (A: 33, B: 31 patients), warfarin (A: 9, B: 22 patients), and clopidogrel (A: 20, B: 11 patients). Before colonic EMR, heparin bridge therapy (A: 20, B: 23 patients) and cilostazol replacement (A: 15, B: 11 patients) were equally performed . There was no significant difference between the two groups in characteristics of colonic polyps. En bloc resection rate was similar successfully between the two groups (94.6% vs 97.8%). EMR procedure was performed by trainees more frequently in group A than B (73.9% vs 48.4%: p< 0.001). There were no significant differences in post EMR bleeding (7.6% vs 4.4%), immediate EMR bleeding (6.5% vs 3.3%) and other adverse events between the two groups. Conclusions: The post EMR bleeding in patients taking antithrombotic agents was similar between saline-epinephrine and hypertonic saline submucosal injection.