{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:49:52Z","timestamp":1792082992114,"version":"4.4.0"},"reference-count":20,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Zhejiang Province Medical and Health Science and Technology Program","award":["2024KY169"],"award-info":[{"award-number":["2024KY169"]}]},{"name":"Zhejiang Province Traditional Chinese Medicine Science and Technology Program","award":["2024ZL720"],"award-info":[{"award-number":["2024ZL720"]}]},{"name":"Hangzhou Municipal Health Science and Technology Program","award":["A20252150"],"award-info":[{"award-number":["A20252150"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,28]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Delayed post-polypectomy bleeding (DPPB) remains a significant complication of endoscopic resection, contributing to morbidity and increased healthcare costs. Although prophylactic clipping is widely practised to mitigate this risk, evidence from recent randomised controlled trials (RCTs) regarding its efficacy is inconsistent. This protocol outlines a systematic review and meta-analysis to evaluate the effectiveness of prophylactic clips following thermal resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct a comprehensive search of MEDLINE, EMBASE and the Cochrane Library from inception to 10 February 2026, to identify RCTs comparing prophylactic clips vs no clips in patients undergoing thermal endoscopic resection of non-pedunculated polyps. The primary outcome is DPPB within 30 days, defined as overt bleeding requiring medical intervention or a haemoglobin decrease \u22652\u2009g\/dL. Secondary outcomes include DPPB in proximal large (\u226520\u2009mm) lesions, perforation, post-polypectomy syndrome and procedure time. Data synthesis will use a random-effects model. Methodological quality will be assessed using the Cochrane Risk of Bias 2 tool. Publication bias will be visualised using funnel plots. We will quantify the effect of potential effect modifiers by meta-regression if appropriate. The quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study will not use primary data, and therefore formal ethical approval is not required. The findings will be disseminated through peer-reviewed journals and committee conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251246840.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-118581","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T18:00:25Z","timestamp":1781200825000},"page":"e118581","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Use of clips to prevent delayed post-polypectomy bleeding in non-pedunculated colorectal lesions: protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"16","author":[{"given":"Yaping","family":"Wei","sequence":"first","affiliation":[{"name":"Hangzhou First People\u2019s Hospital Affiliated of Westlake University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Navy Special Medical Center, Naval Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawa Suleiman","family":"Mabenga","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda John","family":"Ngowi","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8319-1794","authenticated-orcid":false,"given":"Zheng","family":"Jin","sequence":"additional","affiliation":[{"name":"Hangzhou First People\u2019s Hospital Affiliated of Westlake University School of Medicine, Hangzhou, Zhejiang, 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