The role of prophylactic clip application in preventing delayed post-polypectomy bleeding after resection of a colorectal polyp sized 10-25mm
Bibliographic record
Abstract
Aims The routine use of prophylactic clips to prevent delayed post-polypectomy bleeding (PPB) following endoscopic mucosal resection (EMR) continues to be debated. This study aimed to evaluate the effectiveness of prophylactic clip application in reducing DPPB by comparing prospective randomized cohorts that used routine prophylactic clips with a historical control cohort that did not receive any prophylactic measures. Methods Between December 2020 and November 2021, patients with 10-25 mm-sized colorectal polyps planning to undergo EMR were prospectively enrolled at a single academic center. They were randomly assigned to the EZ clip or Core Clip group. A historical control group with no use of prophylactic clips was identified through retrospective chart review. We compare the incidence of PPB between the groups. Immediate PPB was defined as spurting bleeding immediately following polypectomy, or oozing bleeding that lasts for more than 1 minute. The occurrence of delayed PPB was assessed on post-polypectomy day 1 and 7-14, respectively. Results A total of 157, 158, and 167 colorectal polyps were enrolled in the no clip, EZ clip, and Core clip groups, respectively. The size of colorectal polyps was 14.1±4.5 mm, 13.5±4.3 mm, and 13.9±4.5 mm, respectively ( P =0.483). Cut vessels on post-EMR ulcers were observed in 15.3%, 19.6%, and 16.2%, respectively ( P =0.555). Immediate PPB occurred in 9.6%, 15.8%, and 16.2% respectively ( P =0.159). Delayed PPB within 1 day of the procedure was observed in 0.6% (n=1), 1.9% (n=3) and 0.6% (n=1), respectively ( P =0.427). No patient experienced PPB after post-polypectomy day 1 and there were no incidents of perforation of post-polypectomy electrocoagulation within post-polypectomy days 7-14. There were no significant differences between any two groups regarding complications, including PPB, perforation, and electrocoagulation. Conclusions The prophylactic application of endoscopic clips may not prevent delayed post-polypectomy bleeding after resection of colorectal polyps sized 10-25 mm. Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".