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要旨●2014年11月〜2016年6月にCSPを施行された828例2,231病変を対象に,多剤併用を含む抗血栓薬服用者に対するCSPの安全性について検討した.抗血栓薬服用者は全体の19.3%(160例)で,うち多剤併用例は13.1%であった.止血クリップはCSP施行医判断で併用した.後出血を内服例に4例(2.5%)認めたが,穿孔は認めなかった.多変量解析の結果,後出血のリスクは“切除個数”のみで有意であった(p=0.03).CSPは抗血栓薬内服者においても安全に施行可能だが,多数のポリープを切除する際には後出血に注意が必要である.
To determine the safety of CSP(cold snare polypectomy)for patients on antithrombotic agents, we reviewed CSP cases(828 patients, 2,231 polyps)in our hospital between November 2014 and June 2016. A total of 160 patients(19.3% of all cases)were on antithrombotic agents, and 21 patients(13.1% of antithrombotic patients)were on combination antithrombotic therapy. In regards to post-operative complications, only four cases(0.4%)of delayed bleeding were experienced. No cases of perforation were observed. A sub-analysis showed that the number of resected polyps by single endoscopic procedure was equivalent to the risk factor of delayed bleeding(p=0.03). CSP could be a good endoscopic treatment option, even for patients taking antithrombotic agents. However, it is important to pay attention to delayed bleeding, especially when several polyps are resected.
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