{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:07Z","timestamp":1787004847223,"version":"build-2736575974"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background\u2002Delayed bleeding is the most common significant complication after piecemeal endoscopic mucosal resection (p-EMR) of large nonpedunculated colorectal polyps (NPCPs). Risk factors for delayed bleeding are incompletely defined. We aimed to determine risk factors for delayed bleeding following p-EMR.<\/jats:p>\n                  <jats:p>Methods\u2002Data were analyzed from a prospective tertiary center audit of patients with NPCPs\u200a\u2265\u200a20\u200amm who underwent p-EMR between 2010 and 2012.\u200aPatient, polyp, and procedure-related data were collected. Four post p-EMR defect factors were evaluated for interobserver agreement and included in analysis. Delayed bleeding severity was reported in accordance with guidelines. Predictors of bleeding were identified.<\/jats:p>\n                  <jats:p>Results\u2002Delayed bleeding requiring hospitalization occurred after 22 of 330 procedures (6.7\u200a%). A total of 11 patients required blood transfusion; of these, 4 underwent urgent colonoscopy, 1 underwent radiological embolization, and 1 required surgery. Interobserver agreement for identification of the four post p-EMR defect factors was moderate (kappa range 0.52\u200a\u2013\u200a0.57). Factors associated with delayed bleeding were visible muscle fibers (P\u200a=\u200a0.03) and the presence of a \u201ccherry red spot\u201d (P\u200a=\u200a0.05) in the post p-EMR defect. Factors not associated with delayed bleeding were American Association of Anesthesiologists class, aspirin use, polyp size, site, and use of argon plasma coagulation.<\/jats:p>\n                  <jats:p>Conclusions\u2002Visible muscle fibers and the presence of a \u201ccherry red spot\u201d in the resection defect were associated with delayed bleeding after p-EMR. These findings suggest evaluation and photodocumentation of the post p-EMR defect is important and, when considered alongside other patient and procedural factors, may help to reduce the incidence and severity of delayed bleeding.<\/jats:p>","DOI":"10.1055\/a-0577-3206","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T18:40:03Z","timestamp":1523040003000},"page":"790-799","source":"Crossref","is-referenced-by-count":25,"title":["Factors associated with delayed bleeding after resection of large nonpedunculated colorectal polyps"],"prefix":"10.1055","volume":"50","clinical-trial-number":[{"clinical-trial-number":"isrctn99658893","registry":"10.18810\/isrctn"}],"author":[{"given":"Timothy","family":"Elliott","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital and Academic Institute, London, United Kingdom"},{"name":"The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zacharias","family":"Tsiamoulos","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital and Academic Institute, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwan","family":"Thomas-Gibson","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital and Academic Institute, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital and Academic Institute, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas","family":"Bourikas","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital and Academic Institute, London, United Kingdom"},{"name":"Department of Gastroenterology, University of Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailsa","family":"Hart","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Unit, St Mark\u2019s Hospital and Academic Institute, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Bassett","sequence":"additional","affiliation":[{"name":"Statsconsultancy LTD, Amersham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Saunders","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital and Academic Institute, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,4,6]]},"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0577-3206.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T05:17:29Z","timestamp":1550553449000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0577-3206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,6]]},"references-count":0,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2018,7,26]]},"published-print":{"date-parts":[[2018,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0577-3206","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,6]]}}}