News Release

Is it reasonable to perform polypectomy without interruption of anticoagulation?

Peer-Reviewed Publication

World Journal of Gastroenterology

Currently, patients taking anticoagulants to prevent stroke and blood clots are often recommended to stop these medications in order to perform colonoscopy with removal of polyps.

However, interruption of these medications can place patients at risk of stroke and blood clots. A group led by Shai Friedland at the VA Palo Alto hospital in California reported their experience removing small colon polyps without interrupting anticoagulation. Their study will be published on April 28, 2009 in the World Journal of Gastroenterology

Two hundred and twenty five polypectomies were performed in 123 patients. Patients followed a standardized protocol that included stopping warfarin for 36 h to avoid supratherapeutic anticoagulation from the bowel preparation. Patients with lesions larger than 1 cm were generally rescheduled for polypectomy off warfarin. Endoscopic clips were routinely applied prophylactically.

They reported that one patient (0.8%, 95% CI: 0.1%-4.5%) developed major post-polypectomy bleeding that required transfusion. Two others (1.6%, 95% CI: 0.5%-5.7%) had self-limited hematochezia at home and did not seek medical attention. The average polyp size was 5.1 ± 2.2 mm. They announced that polypectomy can be performed in therapeutically anticoagulated patients with lesions up to 1 cm in size with an acceptable bleeding rate.

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Reference: Friedland S, Sedehi D, Soetikno R. Colonoscopic polypectomy in anticoagulated patients. World J Gastroenterol 2009; 15(16): 1973-1976
http://www.wjgnet.com/1007-9327/15/1973.asp

Correspondence to: Shai Friedland, MD, Division of Gastroenterology, GI-111, VA Palo Alto and Stanford University, 3801 Miranda Avenue, Palo Alto, CA 94304, United States. shai_friedland@yahoo.com

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.


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