| Theme | Risk Management in Colonoscopy | |
|---|---|---|
| Title | Management of Anticoagulation and Antiplatelet Therapy in Colonoscopic Treatment | |
| Publish Date | 2016/11 | |
| Author | Kenji Takashima | Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East |
| Author | Hiroaki Ikematsu | Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East |
| [ Summary ] | In 2012, the Japan Gastroenterological Endoscopy Society (JGES) revised the gastroenterological endoscopy guidelines for patients receiving anticoagulant therapy. The guidelines focus on the prevention of thromboembolism. The Japanese guidelines recommend colonoscopic biopsies without interruption of anticoagulant therapy and colonoscopic treatment (polypectomy, endoscopic mucosal resection [EMR], and endoscopic submucosal dissection [ESD]), with continuing low?dose aspirin therapy in patients. Colonoscopic treatment causes post?operative bleeding at a constant rate. Previous studies have reported that the post?operative bleeding rate was approximately 1.0?1.7 % after polypectomy and EMR and approximately 1.0?2.8 % after ESD. In clinical practice, endoscopists need to balance the risks of hemorrhage after colonoscopic treatment and thromboembolic events. However, data supporting these strategies are insufficient. In this report, I have discussed the management of anticoagulation and antiplatelet therapy in colonoscopic biopsies and treatment. |
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