| Theme | Management of antithrombotic agents for colorectal endoscopic procedures -- Validity of new guideline by Japan Gastroenterological Endoscopy Society | |
|---|---|---|
| Title | Current status of revised guidelines -- Real intention of gastroenterologists | |
| Publish Date | 2014/09 | |
| Author | Reiji Higashi | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Masaki Kunihiro | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Toru Yamabe | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Yuki Fujii | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Yuka Oobayashi | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Ken Hirao | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Tsuneyoshi Ogawa | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Masahiro Nakagawa | Department of Endoscopy, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| Author | Motowo Mizuno | Department of Internal Medicine, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens Hospital |
| [ Summary ] | Growth of our elderly population and westernization of our diet have led to a rise in the number of patients with atherosclerotic diseases in Japan. Endoscopists are facing increased opportunities to perform colonoscopic treatment on patients who are receiving antithrombotic agents. The guidelines on management of antithrombotic agents for patients undergoing colonoscopic treatment was renewed in 2012, in order to address the importance of avoiding thromboembolic complications from discontinuing antithrombotic agents. The number of patients who underwent colonoscopic treatment while continuing antithrombotic agents increased significantly after the issuance of the new guidelines. The number of resected polyps, the prevalence of antithrombotic agent use, and the frequency of delayed bleeding did not change significantly. Our analysis of the risk factors associated with delayed bleeding connected with colonoscopic treatment indicates that the use of antiplatelet agents is not a risk factor. The only independent risk factor was the use of anticoagulant agents. Moreover, at our center, we experienced a case in which a patient, whose anticoagulant was replaced with heparin before treatment, had bleeding that was uncontrollable endoscopically. We strongly suggest that anticoagulant agents for patients undergoing colonoscopic treatment must be managed extremely cautiously. |
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