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December 4, 2019

To clip or not to clip after polypectomy

Experts debate the usefulness and efficiency of using clips during a colonoscopy.
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Men and women are encouraged to get a colonoscopy at age 50 to help prevent colorectal cancer — age 45 for some groups. The procedure involves the endoscopic resection of pre-cancerous polyps but is associated with a risk of serious adverse events, including bleeding.

Prophylactic clips can be placed during the procedure itself to prevent bleeding following polypectomy.

Fadi Antaki, MD, AGAF, argues that prophylactic clips should be used for selected polyps as it will reduce this risk and add a level of safety to the intervention.

Rajesh N. Keswani, MD, MS, makes the case that outside of a narrow subgroup, we cannot confidently say that endoscopic clips are effective as it increases procedure time and costs, and is reliant upon the individual skill of each endoscopist using clips.

Review this debate and other expert discourse in AGA Perspectives.

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