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Colonic endoscopic mucosal resection in patients taking anticoagulants: Is heparin bridging therapy necessary?
Author(s) -
Fujita Minoru,
Murao Takahisa,
Osawa Motoyasu,
Hirai Shinsuke,
Fukushima Shinya,
Yo Syogen,
Nakato Rui,
Ishii Manabu,
Matsumoto Hiroshi,
Tamaki Takahiko,
Sakakibara Takashi,
Shiotani Akiko
Publication year - 2018
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12598
Subject(s) - medicine , exacerbation , surgery , anemia , heparin , gastroenterology
OBJECTIVE Heparin bridging therapy (HBT) reportedly increases the risk of post‐procedural bleeding, and its safety during endoscopic interventions remains unclear. We aimed to evaluate the effects of peri‐procedural HBT in patients taking anticoagulants who underwent colonic endoscopic mucosal resection (EMR) for polyps. METHODS Patients who underwent colonic EMR while taking a single anticoagulant agent were enrolled in this study. Anticoagulants were temporarily ceased in all patients either without (the non‐HBT group, prospectively enrolled) or with HBT (the HBT group, retrospectively enrolled). The incidences of post‐procedural bleeding and anemia exacerbation and their length of hospitalization were evaluated and compared. RESULTS There were altogether 43 consecutive adult patients (30 men; mean age 72.2 ± 7.4 years) in the non‐HBT group and 41 sex‐ and age‐matched adults (32 men; mean age 72.9 ± 8.3 years) in the HBT group. There were no significant differences in the location, number or size of resected polyps between the two groups. The percentage of patients with post‐procedural bleeding within 2 weeks after colonic EMR in the non‐HBT group was lower than that in the HBT group (2.3% vs 9.8%, P = 0.15), although the frequency of anemia exacerbation was not significantly different between the two groups. The total hospitalization length was shorter in the non‐HBT compared with the HBT group (4.5 days vs 6.0 days, P < 0.001). CONCLUSIONS No patient in either group developed embolism during hospitalization. Colonic EMR with the temporary cessation of anticoagulants without HBT may be acceptable and beneficial for patients taking anticoagulants.