{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T03:05:31Z","timestamp":1765422331780,"version":"3.28.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims Prophylactic closure of endoscopic resection defects reduces delayed hemorrhage after resection of non-pedunculated colorectal lesions \u2265 20 mm that are located proximal to the splenic flexure and removed by electrocautery. The risk of delayed hemorrhage after cold (without electrocautery) resection is much lower, and prophylactic clip closure after cold resection is generally unnecessary. The aim of this study was to audit clip use after colorectal polyp resection in routine outpatient colonoscopies at two outpatient centers within an academic medical center. Patients referred for resection of known lesions were excluded.<\/jats:p><jats:p>\n            Patients and methods Retrospective chart analysis was performed as part of a quality review of physician adherence to screening and post-polypectomy surveillance intervals.<\/jats:p><jats:p>\n            Results Among 3784 total lesions resected cold by 29 physicians, clips were placed after cold resection on 41.7% of 12 lesions \u2265 20 mm, 19.3% of 207 lesions 10 to 19 mm in size, and 2.8% of 3565 lesions 1 to 9 mm in size. Three physicians placed clips after cold resection of lesions 1 to 9 mm in 18.8%, 25.5%, and 45.0% of cases. These physicians accounted for 8.1% of 1- to 9-mm resections, but 69.7% of clips placed in this size range. Electrocautery was used for 3.1% of all resections. Clip placement overall after cold resection (3.9%) was much lower than after resection with electrocautery (71.1%), but 62.4% of all clips placed were after cold resection.<\/jats:p><jats:p>\n            Conclusions Audits of clip use in an endoscopy practice can reveal surprising findings, including high and variable rates of unnecessary use after cold resection. Audit can potentially reduce unnecessary costs, carbon emissions, and plastic waste.<\/jats:p>","DOI":"10.1055\/a-2284-9739","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:10:05Z","timestamp":1710202205000},"page":"E579-E584","source":"Crossref","is-referenced-by-count":5,"title":["Audit of hemostatic clip use after colorectal polyp resection in an academic endoscopy unit"],"prefix":"10.1055","volume":"12","author":[{"given":"Easton M.","family":"Stark","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel E.","family":"Lahr","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremiah","family":"Shultz","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna C.","family":"Vemulapalli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Guardiola","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas K.","family":"Rex","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School 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McWhinney","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.gie.2022.03.006","article-title":"Cold versus hot snare resection with or without submucosal injection of 6- to 15-mm colorectal polyps: a randomized controlled trial","volume":"96","author":"DK Rex","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1055\/a-2129-5752","article-title":"Cold snare endoscopic mucosal resection for colon polyps: a systematic review and meta-analysis","author":"M Abdallah","year":"2023","journal-title":"Endoscopy"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1055\/a-2029-9539","article-title":"Effectiveness and safety of cold snare polypectomy and cold endoscopic mucosal resection for nonpedunculated colorectal polyps of 10\u201319 mm: a multicenter observational cohort study","author":"D 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