Clip endoscópico para la prevención del sangrado después de la resección de pólipos colorrectales

Abstract

Colorectal polyps are lesions that protrude from the surface of the mucosa into the lumen of the colorectum. They are treated surgically, and bleeding is the most common complication during the procedure. However, 10% of patients may bleed for up to 3 days after resection, which is usually managed by endoscopic hemostasis using coagulation forceps, adrenaline injections, and thermal coagulation methods. Currently, endoscopic clips have gained popularity as a new hemostatic technique. Despite their good results, they have limitations depending on patient-specific factors and the technique applied by the endoscopist. This literature review aims to describe the efficacy of endoscopic clips as a preventive measure for bleeding after colorectal polyp resection. Considering the benefits and limitations of the technique, several authors justify that clipping is appropriate according to clinical criteria and the individual characteristics of the patient. However, others contrast this with evidence suggesting the lack of efficacy of routinely use of clips to close resection sites, especially in polyps smaller than 20 mm. The effectiveness of clips for prophylactic purposes in bleeding remains controversial due to the significant gap in the standardization of data collected across different studies. The size of the polyps, resection technique, number of clips used to close the lesion, and endoscopist training are the main factors that affect the results