Department of Digestive Endoscopy, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital , N0.134, East Avenue, Fuzhou 350001, Fujian Province, China. Department of Gastrointestinal surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital , N0.134, East Avenue, Fuzhou 350001, Fujian Province, China.
INTRODUCTION The most common complication of post-colorectal endoscopic resection is delayed bleeding. The assessment of risk factors for delayed bleeding provide important and useful information in standard clinical operations. The risk factors have been previously reported, however they remain inconsistent across different studies. AREAS COVERED In this meta-analysis the patient conditions, lesion-related factors, and operation-related factors were compared between delayed
bleeding and no bleeding. PubMed, Cochrane, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang Database were searched to identify eligible studies. Pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated along with heterogeneity. EXPERT OPINION This study is the first meta-analysis to investigate risk factors for colorectal delayed bleeding. We found several risk factors contributing to this condition: colorectal tumors located in the proximal colon, a history of antithrombotic drug use, high-grade intraepithelial neoplasia or early cancer, piecemeal resection, intraoperative hemorrhage, no clip placement, and severe submucosal fibrosis. Despite our findings, we also conclude that more high-quality, large-scale clinical randomized controlled studies are needed due to limited retrospective studies at present. Future therapeutic colonoscopies should focus on precise diagnosis, treatment safety, and management during the perioperative period.