| International Session（Workshop）3(JGES・JSGE・JSGS・JSGCS) |
| Sat. November 4th 14:00 - 16:30 Room 11: Portopia Hotel South Wing Topaz |
| Continuous Warfarin administration versus Heparin bridging therapy in post colorectal polypectomy haemorrhage (WHICH study) | |||
| Shigetsugu Tsuji1, Yasuaki Nagami2, Takayuki Katsuno3 | |||
| 1Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 2Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, 3Department of Gastroenterology, Izumiotsu Municipal Hospital | |||
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| Aims; While heparin bridge (HB) has been a standard strategy for colorectal polypectomy in patients taking warfarin, continuous warfarin administration (CWA) was expected not to increase post-polypectomy bleeding (PPB) without hospitalization. We conducted a prospective multicenter randomized controlled non-inferiority trial comparing PPB between CWA and HB. Methods; Patients taking warfarin who would undergo colorectal polypectomy were enrolled. Enrolled patients were assigned to the CWA and HB groups in a 1 to 1 ratio and underwent polypectomy using electrocautery. The primary outcome measure was the PPB rate. Results; A total of 325 patients were enrolled and 316 underwent randomized. After each 7 patient was excluded, 151 in each group were analysed. PPB occurred in 7.9% in CWA and 23.6% in the HB group, respectively. The intergroup difference for the primary outcome was -15.7% (95%CI; -24.0% to -7.7%), which was lower than the pre-set non-inferiority margin of 5% (p<0.001). Hospitalization period was 3 days in CWA and 13 days in the HB group (p<0.001). Conclusions; In patients taking warfarin, CWA did not increase PPB with shorter hospitalization, compared to HB. |
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Index Term 1: polypectomy Index Term 2: anticoagulant |
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