Heitman, StevenForbes, Nauzer2018-01-082018-01-082017-12-12Forbes, N. (2017). Practice Patterns, Predictors of Use and Clinical Efficacy of Endoscopic Clips for Prevention of Delayed Post-polypectomy Bleeding (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.http://hdl.handle.net/1880/106243Colonoscopy reduces colorectal cancer through the removal of pre-cancerous polyps, which exposes patients to potential adverse events. Endoscopic clips are used by practitioners to prevent delayed post-polypectomy bleeding. This thesis reports the results of two studies performed with the aim of evaluating the practice patterns and clinical efficacy of prophylactic clipping during polypectomy. A meta-analysis of randomized trials showed that prophylactic clipping is not efficacious in preventing delayed bleeding during routine polypectomy, especially among polyps < 10 mm. A large retrospective cohort study then described clinical parameters associated with clip usage. We demonstrated that use of clips increased over time in a high-volume outpatient endoscopy unit. Furthermore, a high degree of variability in clipping patterns existed between endoscopists, including among polyps < 10 mm, where no efficacy exists. Taken together, these results reveal an urgent need for effective knowledge translation to eliminate this ineffective and costly practice during routine polypectomy.enUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.Medicine and Surgerymaster thesis10.11575/PRISM/5241