Clip Closure Prevents Bleeding After Endoscopic Resection of Large Colon Polyps

Resection of colorectal polyps is one of the most frequently performed medical interventions, and removal of precancerous polyps is an important means of reducing cancer incidence and mortality. Although most colorectal polyps are small, larger ones represent a higher cancer risk and their careful, complete, and timely removal is especially critical. Endoscopic resection has replaced surgical resection as the primary treatment for large colon polyps because of a lower morbidity and less need for hospitalization. Postprocedure bleeding is the most common severe complication, occurring in 2% to 24% of patients. Proximal polyp location in the colon, polyp size, and use of antithrombotic medications are factors that have been associated with an increased risk of postprocedure bleeding. In a randomized trial, we found that endoscopic clip closure of the mucosal defect following resection of large colon polyps reduces risk of postprocedure bleeding. The protective effect appeared to be restricted to large polyps located in the proximal colon.