Table 4.

Complications section, key points

• Diagnostic colonoscopy is extremely safe. Complications arise mostly from polypectomy with electrocautery.

• Bleeding is the most frequent complication of polyp removal (0.3–2% for diminutive and small polyps; 1–10% for endoscopic mucosal resection/endoscopic submucosal resection). In most cases, it is managed endoscopically. Risk factors include increased size and right colon location. Antiplatelet, or even anticoagulation agents do not seem to be risk factors for bleeding in small and diminutive polyps, whilst they are considered such for large polyps.

• Perforation is the second most common complication (0% for small and diminutive polyps if electrocautery is avoided; 0–1.5% for endoscopic mucosal resection and 1.5–10% for endoscopic submucosal resection in large polyps). Most cases can be managed endoscopically. Risk factors include lack of experience, larger size and right colon location.

• Post-polypectomy coagulation syndrome is rare (1–4% of cases; but only 0.07% require hospitalization). It is easily managed conservatively.