TỶ LỆ CHẢY MÁU VÀ CÁC YẾU TỐ LIÊN QUAN SAU NỘI SOI CẮT POLYP ĐẠI–TRỰC TRÀNG Ở BỆNH NHÂN XƠ GAN

Abstract

Objective: To describe the incidence of bleeding in patients with cirrhosis following endoscopic colorectal polypectomy and to analyze factors associated with post-procedural bleeding in this population. Methods: A prospective cross-sectional descriptive study was conducted on 58 cirrhotic patients who underwent colorectal polypectomy using hot snare technique at the Department of Gastroenterology, 198 Hospital (Ministry of Public Security) and the Gastroenterology and Hepatology center, Bach Mai Hospital, from May 2024 to July 2025. Data were analyzed using STATA version 17.0, and multivariate logistic regression was applied to identify factors associated with bleeding. Results: A total of 145 polyps were removed in 58 patients using hot snare polypectomy. The overall post-polypectomy bleeding rate in cirrhotic patients was 24,14%, including immediate bleeding in 17,24% and delayed bleeding in 6,9%. Statistically significant factors associated with bleeding included: Child–Pugh class B cirrhosis (OR = 2.45; p = 0.04), polyp size 10–19 mm (OR = 3.21; p = 0.03), polyp size ≥20 mm (OR = 6.20; p = 0.02), histopathology showing high-grade dysplasia (OR = 2.84; p = 0.02), and hot snare polypectomy with submucosal injection lift (OR = 3.12; p = 0.014). Conclusion: Post-polypectomy bleeding is a notable complication in cirrhotic patients, particularly in cases with decompensated cirrhosis and large polyps