Can reduce the incidence of colorectal cancer by 76-90%.

Perforation occurs in one in 500 procedures.

Associated with hemorrhage three in 1000.

Large polyp size and other patient factors such as the use of anticoagulants are associated with an increased risk of immediate and delayed postpolypectomy bleeding.

Increased risk of postpolypectomy bleeding are associated with age of greater than 65 years, cardiovascular disease, use of pure cutting current during polypectomy and sessile polyp morphology.

5% of patients experience complications and 2% require hospitalization.

Postpolypectomy bleeding sequelae are rare

Polypectomy in patients with adenomas can prevent approximately 80% of colorectal cancers.

National Polyp Study demonstrated colorectal cancer was prevented by colonoscopic polypectomy in a study mortality from colorectal cancer.

In a study of 2602 patients with adenomas removed during the participation of the study after a median of 15.8 years, 12 died from colorectal cancer with expected estimated 25.4 deaths, suggesting a 53% reduction in mortality(National Polyp Study).

In the above study mortality from colorectal cancer was similar among patients with adenomas and those with non-adenomatous polyps during the first years after polypectomy(Zauber AG et al).

Retrospective studies show that aspirin can be safely continued during colonoscopy with polypectomy without concern for a significant increase in bleeding.

NSAIDs, which reversibly block cyclooxygenase, can be used safely prior to colonoscopy procedures.

Continuing thienpyridine agents during polypectomy is estimated the risk of clinically important post polypectomy bleeding at 0.9 to 2.1%.

A retrospective study showed that the use of periprocedural anticoagulation found that delayed postpolypectomy bleeding occurred in 2.6% of patients who discontinued warfarin prior to colonoscopy, compared with 0.2% of patients not anticoagulated.

Risk of bleeding with heparin int2242uption is greater than 20% than those without bridging therapy at 1.4%.

Resuming warfarin within one week of polypectomy increased the risk of the late postpolypectomy bleeding more than five fold.

2020 recommendations for a follow-up colonoscopy after polypectomy:
Repeat colonoscopy is recommended 7-10 years, if to complete removal of one-two tubular adenomas smaller than 10 mm.
Repeat colonoscopy is recommended 3-5 years after complete removal of 3-4 tubular adenomas smaller than 10 mm.
Repeat colonoscopy is recommended three years at the complete removal of 5-10 tubular adenomas smaller than 10 mm.
Repeat colonoscopy is recommended three years after complete removal of one or more adenomas  10 mm or larger.
Repeat colonoscopy is recommended six months after piecemeal resection of an adenoma or sessile s2242ated polyp 20 mm or larger.

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