Prophylactic clip closure for the prevention of delayed bleeding after colorectal endoscopic submucosal dissection: a systematic review and meta-analysis of randomized controlled trials.

Publication/Presentation Date

6-12-2026

Abstract

Prophylactic clip closure after endoscopic submucosal dissection (ESD) may be beneficial in the prevention of adverse events. In this meta-analysis of randomized controlled trials, we have evaluated the role of prophylactic clipping after ESD. We reviewed multiple databases from inception to 24 January 2026. Outcomes of interest included post-ESD bleeding, perforation, and post-ESD coagulation syndrome. Risk ratios with 95% confidence intervals (CIs) were calculated. Data were analyzed using a random-effects model. Heterogeneity was assessed using the I2 statistic. Five randomized controlled trials with 772 patients were included. Prophylactic clipping was associated with a lower risk of post-ESD bleeding (risk ratio: 0.35, 95% CI: 0.18, 0.65). There was no significant difference in risk of post-ESD coagulation syndrome (risk ratio: 1.06, 95% CI: 0.73, 1.53), and perforation (risk ratio: 0.72, 95% CI: 0.23, 2.30) between the groups. In conclusion, this meta-analysis demonstrates the benefits of prophylactic clipping after colorectal ESD in the prevention of post-ESD bleeding.

ISSN

1473-5687

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

42467919

Department(s)

Administration and Leadership

Document Type

Article

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