Continuous warfarin administration versus heparin bridging therapy in post colorectal polypectomy haemorrhage: a study protocol for a multicentre randomised controlled trial (WHICH study)

Abstract Background Endoscopic removal of colorectal adenoma is considered an effective treatment for reducing the mortality rates associated with cancer. Warfarin, a type anticoagulant, widely used and prevention thromboembolism; however, bleeding may increase its administration after polypectomy. In recent times, high incidence endoscopic polypectomy has been reported in patients receiving heparin bridge therapy. However, previous studies have not compared rate between who continued anticoagulant therapy those received We hypothesised that under novel continuous warfarin inferior to standard respect postoperative bleeding. This study aims compare efficacy Methods will conduct prospective multicentre randomised controlled non-inferiority trial two parallel groups. scheduled undergo warfarin. There be 2 groups, namely, group (heparin therapy) experimental (continued therapy). The primary outcome measure On contrary, secondary outcomes include cumulative bleeding, overt haemorrhage (that does qualify definition polypectomy), requiring haemostasis during polypectomy, intraoperative angiography, abdominal surgery and/or blood transfusion, total risk factors length hospital stay, thromboembolism, prothrombin time-international ratio (PT-INR) 28 days surgery, serious adverse events. Discussion results this provide valuable information standardisation management anticoagulants Trial registration UMIN-CTR UMIN000023720 . Registered on 22 August 2016