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Current evidence is mixed as to whether use of hemostatic clips prevents delayed hemorrhage in closure of large EMR (endoscopic mucosal resection) sites. In the current randomized, controlled trial, investigators at a single center in China evaluated adverse events in 348 patients with large (1–4 cm) colorectal lesions who underwent endoscopic resection with or without clip closure.
The rates of the adverse events in the clip-closure and no-closure groups, respectively, were:
Delayed postoperative bleeding: 1.1% vs. 6.9% (P=0.01)
Postpolypectomy syndrome: 0.6% vs. 4.6% (P=0.03)
Abdominal pain: 2.8% vs. 16.7% (P=0.002)
One perforation occurred in each group. The average number of clips placed was seven, and the mean additional time per procedure …