Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 28, 2009; 15(16): 1973-1976
Published online Apr 28, 2009. doi: 10.3748/wjg.15.1973
Colonoscopic polypectomy in anticoagulated patients
Shai Friedland, Daniel Sedehi, Roy Soetikno
Shai Friedland, Daniel Sedehi, Roy Soetikno, Division of Gastroenterology, GI-111, VA Palo Alto and Stanford University, 3801 Miranda Avenue, Palo Alto, CA 94304, United States
Author contributions: Friedland S and Sedehi D performed data collection, analysis and writing of the manuscript; Soetikno R performed data analysis and writing of the manuscript.
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
Telephone: +1-650-4935000
Fax: +1-650-8490505
Received: January 4, 2009
Revised: March 26, 2009
Accepted: April 2, 2009
Published online: April 28, 2009
Abstract

AIM: To review our experience performing polypectomy in anticoagulated patients without interruption of anticoagulation.

METHODS: Retrospective chart review at the Veterans Affairs Palo Alto Health Care System. 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.

RESULTS: 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.

CONCLUSION: Polypectomy can be performed in therapeutically anticoagulated patients with lesions up to 1 cm in size with an acceptable bleeding rate.

Keywords: Colon cancer; Colonic polyps; Colonoscopy; Early detection of cancer; Endoscopy; Hemorrhage; Thrombosis; Warfarin