Prospective Analysis of Minor Adverse Events After Colon Polypectomy.

BACKGROUND: The risks of minor adverse events (MAEs) such as abdominal pain and bloating after colon polypectomy (CP) are less clearly documented than major adverse events. However, these complications may cause significant discomfort during the performance of normal activities. We aimed to estimate the incidence of MAE, associated risk factors, and healthcare resource utilization after CP. METHODS: Patients who underwent CP were prospectively enrolled in this study. Trained nurses contacted patients by telephone at 7 and 30 days after the CP and administered a standardized questionnaire to obtain information regarding the development of complications. MAEs were defined as any discomfort the patient experienced after CP excluding major bleeding, perforation, and post-polypectomy coagulation syndrome. RESULTS: Among a total of 2716 patients, 2253 patients completed the interview at 7 and 30 days. MAEs occurred in 263 patients (11.7%) before day 7, among which the most common were abdominal pain (4.5%), rectal bleeding (2.8%), and bloating (2.6%). Cumulative incidence of MAEs was in 267 patients (11.9%) at 30 days. On multivariate analysis, female sex (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.58-3.18) and use of meperidine (OR 1.54, 95% CI 1.04-2.27) were risk factors for the occurrence of MAEs. Two patients (0.7%) required hospital admission, 117 patients (43.8%) were treated medically in the outpatient clinic, and the majority at 148 patients (55.4%) experienced resolution of symptoms after observation. CONCLUSIONS: The post-CP MAE rate was as low as 11.8%. The MAEs occurred mainly in the first seven postoperative days and resulted in little use of healthcare resources.

Fecal hemoglobin concentration is useful for risk stratification of advanced colorectal neoplasia.

BACKGROUND: Although a fecal immunochemical test (FIT) allows quantitation of fecal hemoglobin (f-Hb), it is typically used as a binary result to identify subjects above a predetermined cut-off concentration. AIMS: To investigate whether f-Hb concentration is useful for risk stratification of advanced colorectal neoplasia (CRN). METHODS: This was a retrospective study conducted in a university hospital in Korea. Of 34,547 participants who underwent FIT from June 2013 to May 2015, 1532 (4.4%) showed positive results (≥100ng Hb/ml). Of participants with positive results, 738 subjects aged ≥50 years who underwent colonoscopy were analyzed. RESULTS: Increasing quartile of f-Hb concentration (Q4 vs. Q1; odds ratio, 3.87; 95% confidence interval, 2.36-6.34), as well as older age, male sex, smoking, and metabolic syndrome (MetS), was significantly associated with a higher prevalence of advanced CRN. Risk for advanced CRN increased 5.13-, 4.27-, 5.12-, and 7.15-fold, respectively, among individuals with f-Hb in the fourth quartile who had risk factors such as age ≥70 years, male sex, smoking, and MetS compared with individuals with first quartile levels of f-Hb who did not have those risk factors. CONCLUSION: In addition to age, sex, smoking status, and MetS, f-Hb concentration in individuals with positive results from FIT can be used to stratify the probability of detection of advanced CRN.