Endoscopy
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See the full rubric →Prophylactic clip closure after right-colon endoscopic mucosal resection in a matched cohort of 470 patients exhibits sub-site heterogeneity.
Clinical takeawayConsider routine clip closure for right-colon EMR of large non-pedunculated polyps ≥20 mm, especially at the hepatic flexure and ascending colon; partial apposition appears sufficient. This is based on exploratory sub-site analyses.
What it foundProphylactic clip closure reduced post-EMR bleeding to 3.4% vs 11.1% in unclipped patients (RR 0.31, NNT 13), with benefit concentrated at the hepatic flexure (0% vs 17.2%) and ascending colon (2.0% vs 10.1%).
ContextConfirms and refines prior conflicting trial data by showing site-specific benefit in a matched cohort of 470 patients, with exploratory analyses suggesting partial closure may be as effective as complete closure.
No standard claimed for this paper
Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.
Eitan M … Bourke MJ · Endoscopy · IF 11.8 · PubMed ↗