Colonoscopic Sucralfate Spray in Prevention of Delayed Polypectomy Bleeding
Status:
Recruiting
Trial end date:
2024-04-14
Target enrollment:
Participant gender:
Summary
Background： Colonoscopy can detect colon polyps and perform excision to the polyps to prevent
colon cancer. However, polypectomy bleeding is one of the complications to be noticed, which
has an occurrence rate of about 0.4%. Polypectomy bleeding is divided into two types,
immediate and delayed bleeding. While immediate polypectomy bleeding can be treated with
endoscopic hemostasis during the exam session, delayed polypectomy bleeding occurs a few
hours or days after the colonoscopy exam. Patients who encountered delayed polypectomy
bleeding usually presented to the hospital for hematochezia, symptoms of anemia, and even
hemodynamic instability and end-organ damage. Cold snare polypectomy and prophylactic
clipping can reduce the bleeding risk. However, delayed polypectomy bleeding still occurs in
high-risk patients, e.g., larger polyps ≥ 1cm. Sucralfate is used for peptic ulcer treatment.
It can become a protective layer on the wound to prevent environmental injury. Sucralfate can
be used to treat colon ulcers, colitis, and radiation colitis. Whether sucralfate can prevent
polypectomy wounds from delayed bleeding is unknown.
Aim： This study aimed to investigate whether precise sucralfate administration on polypectomy
wounds can prevent the wound from delayed bleeding.
Method： This is a randomized clinical trial. The study will recruit 160 patients. After
randomization, 80 patients will be classified into the intervention group and 80 into the
control group. The participants will receive an endoscopic survey as routine, and we will
enroll all patients with polyp size ≥ 0.5 cm after polyp excision. Exclusion criteria include
patients with an allergy to sucralfate. If immediate polypectomy bleeding occurs, we will
apply standard endoscopic therapy by either local injection of diluted epinephrine, heater
probe coagulation, and/or hemoclipping. If there is no immediate bleeding, we will apply
prophylactic clipping in high-risk patients with polyp size ≥ 1cm. After then, we will spray
3g of sucralfate powder through colonoscopy precisely on the polypectomy wound in the
intervention group. All enrolled patients will be monitored for delayed bleeding for 28 days
after the colonoscopy.