Bleeding After GI EndoscopyPhase 4NCT07257926
Prevention of Delayed Post-polypectomy Bleeding by Endoscopic Sucralfate Spray in High-risk Patients: A Randomized Controlled Trial
A Phase 4 study testing Sucralfate and Clip in people with Bleeding After GI Endoscopy, run by National Cheng-Kung University Hospital.
Trial summary
Background： Colonoscopy can detect colon polyps and perform excision to the polyps to prevent colon cancer. However, delayed polypectomy bleeding is one of the complications to be noticed, which has an occurrence rate of about 1-2%, especially large polyps over 1cm with hot snare polypectomy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Bleeding After GI Endoscopy
- What is being tested?
- Sucralfate and Clip
- Type of treatment
- Pill or oral medicine, Injection or infusion, Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 160 participants
- Where
- No sites listed yet
- Study dates
- 15 Dec 2025to 31 Dec 2027
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- patients who take antiplatelets or anticoagulants with large polyps (size ≥ 1 cm)
Who cannot join
- lacked complete data (serum creatinine, platelet count, and prothrombin time) pertaining to the previous 6 months
- those who did not discontinue or inadequately discontinued antiplatelet agents or anticoagulants
- those who had a known allergy to sucralfate
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Background： Colonoscopy can detect colon polyps and perform excision to the polyps to prevent colon cancer. However, delayed polypectomy bleeding is one of the complications to be noticed, which has an occurrence rate of about 1-2%, especially large polyps over 1cm with hot snare polypectomy. Colonoscopic clipping was applied for the treatment of bleeding. However, prophylactic clipping after polypectomy was not proved to reduce the rate of delayed polypectomy bleeding. Sucralfate is used for peptic ulcer treatment, which can become a protective layer on the wound to prevent environmental injury. Our preliminary data revealed the endoscopic sucralfate spray could reduce the delayed bleeding rate among general populations. Whether sucralfate can prevent polypectomy wounds from delayed bleeding in high-risk polyps is unknown.
Aim： This study aimed to compare the efficacy in reducing delayed bleeding rate between sucralfate administration and prophylactic clipping on high-risk polypectomy wounds.
Read more
Method： This is a randomized clinical trial. The study will recruit 160 patients. After randomization, 80 patients will be classified into the Sucralfate group and 80 into the Clipping group. The participants will receive an endoscopic survey as routine, and we will enroll all patients who take antiplatelets or anticoagulants with polyp size ≥ 1 cm after hot snare polyp excision. Exclusion criteria include patients with an allergy to sucralfate. If immediate polypectomy bleeding occurs, we will apply standard endoscopic therapy by either local injection of diluted epinephrine, heater probe coagulation, and/or hemoclipping. After then, we will spray 3g of sucralfate powder through colonoscopy precisely on the polypectomy wound in the Sucralfate group, and prophylactic clipping will be placed on the polypectomy wound in the Clipping group. All enrolled patients will be monitored for delayed bleeding for 28 days after the colonoscopy.
Expected results and clinical importance:
This study is expected to find that the use of sucralfate powder can more effectively reduce the bleeding risk in high-risk wounds compared to prophylactic clips. In addition to promoting the implementation of national health policies and reducing public exposure to the risk of complications, it can also help avoid medical expenses resulting from complications.
Read the detailed description
Colonoscopic polypectomy is a key procedure for prevention of colorectal cancer and reduction of associated mortality risk. However, this procedure carries a risk of postpolypectomy bleeding. Postoperative bleeding can occur immediately (intraoperatively, manageable during colonoscopy) or after a while (for example, a month after colonoscopy). The causes of delayed postpolypectomy bleeding include detachment of eschar due to stool passage and extension of submucosal necrosis due to hot snare polypectomy. The incidence rate of delayed postpolypectomy bleeding ranges from 1% to 2%; this rate increases to 6% in patients with large (> 2 cm) colon polyps. Risk factors for this complication include hot snare polypectomy, chronic kidney disease, liver cirrhosis, antiplatelet agent or anticoagulant use, and pedunculated colon polyps. Delayed postpolypectomy bleeding is a major complication that requires prompt management. Patients with delayed bleeding usually present with hematochezia, anemia, hemodynamic instability, or end-organ damage. Hemostasis often requires repeated colonoscopic procedures and hospitalization, which increases patient discomfort and treatment costs. In complex cases, emergent surgical intervention or transarterial embolization may become necessary. Therefore, the prevention of delayed postpolypectomy bleeding is crucial for both patients and clinicians.
Sucralfate, a basic aluminum salt of sucrose octa sulfate, has been used in the treatment of gastrointestinal ulcers; this powder accelerates healing and prevents bleeding. The mechanisms underlying its effects involve binding to exposed proteins on damaged cells and creating a protective layer that shields the mucosa from further injury. Sucralfate can also bind to growth factors and thus promote angiogenesis and mucosal healing. Pharmacodynamic insights have suggested that local application of sucralfate is more effective in promoting wound healing than systemic administration, likely because of its ability to locally adhere to damaged mucosa, forming a sticky coating that accelerates healing.
Liquid sucralfate has demonstrated healing efficacy in endoscopic mucosal resection-induced gastric ulcers. Rectosigmoid ulcer lesions can also be treated with topical sucralfate by enema. In radiation proctitis and idiopathic ulcerative proctitis, sucralfate enemas produced clinical and endoscopic improvement. Compared to the drug powder, we think the liquid formulation would soon drain away from the wound. Therefore, we assume that the local application of sucralfate powder to polypectomy wounds would effectively prevent delayed postpolypectomy bleeding.
In our preliminary data of a pilot study (IRB: A-BR-111-085, ClinicalTrials.gov ID: NCT05817656), a total of 160 patients with polyps (size≥0.5cm) who had undergone colonoscopic polypectomy were enrolled. divided into the sucralfate and control groups (80 per group). After polypectomy, the patients received standard treatment for immediate bleeding. Then, they were randomly allocated to either a sucralfate group (prophylactic spraying of 3g sucralfate powder on polypectomy wounds) or a control group. As a result, the rate of delayed postpolypectomy bleeding (0% vs 6.3%, respectively; P=0.029) and postpolypectomy overt bloody stool (2.4% vs 18.8%, respectively; P=0.001) were lower in the sucralfate group than in the control group. The duration of freedom from delayed bleeding was longer in the sucralfate group than in the control group (P=0.024). Colonoscopic spraying of sucralfate powder is a safe approach with potential to reduce the risk of delayed postpolypectomy bleeding among the general population.
However, whether this method can be applied to high-risk polyps were indetermined, such as large polyps > 1cm under hot snare polypectomy, especially in those who take antiplatelets or anticoagulants. Moreover, the prophylactic potency comparison between sucralfate spray and prophylactic clips was also unknown. Therefore, a head-to-head comparison between sucralfate powder and clipping is needed to identify the preventative potency.
- Conditions
- Bleeding After GI Endoscopy
- Being tested
- Sucralfate, Clip
- Keywords
- polypectomy, sucralfate, antiplatelet, anticoagulant, postpolypectomy bleeding
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SucralfateDrug
3 g of sucralfate powder will be sprayed on the polypectomy wounds of patients in the Sucralfate group.
ClipDevice
Prophylactic clips will be placed on the polypectomy wounds of patients in the Clipping group
| Study group | Role | What they receive |
|---|---|---|
| Clipping group | Active comparator | After identifying a resectable colon polyp (size ≥ 1 cm), the operator performed a hot polypectomy. Following hot polypectomy, the wound was observed for 30 seconds to detect potential immediate bleeding. Standard endoscopic interventions such as diluted epinephrine injection, heat coagulation, or clipping were promptly administered if immediate bleeding occurred. Subsequently, the patients were randomly assigned to either the Sucralfate or Clipping groups. After allocation, prophylactic clips will be placed on the polypectomy wounds of patients in the Clipping group. Receives: Device: Clip |
| Sucralfate group | Experimental | After identifying a resectable colon polyp (size ≥ 1 cm), the operator performed a hot polypectomy. Following hot polypectomy, the wound was observed for 30 seconds to detect potential immediate bleeding. Standard endoscopic interventions such as diluted epinephrine injection, heat coagulation, or clipping were promptly administered if immediate bleeding occurred. Subsequently, the patients were randomly assigned to either the Sucralfate or Clipping groups. After allocation, 3 g of sucralfate powder will be sprayed on the polypectomy wounds of patients in the Sucralfate group. The powder spray aimed for the full coverage of the polypectomy wound. Six sucralfate tablets (500 mg per Weizip tablet; Yung Shin Pharmaceutical Industries, Taichung, Taiwan) were ground to collect 3 g of sucralfate powder. This powder was then delivered through a functional powder delivery system (7F polyethylene catheter in connection by an oxygen cannula to the air source; propelling power: 1 L/min airflow) Receives: Drug: Sucralfate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of delayed postpolypectomy bleeding
Delayed postpolypectomy bleeding was defined as the need for reintervention or hospitalization, indicating a clinically significant bleeding event
Measured: 28 days
Secondary outcomes (2)
Rate of overt bloody stool
Overt bloody stool with spontaneous bleeding cessation was regarded as minor bleeding
Measured: 2 days
Rate of severe bleeding from polypectomy wounds
bleeding from polypectomy wounds necessitating transarterial embolization or emergency surgery
Measured: 28 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Dec 2025
- Study start15 Dec 2025 (estimated)
- Primary completion31 Dec 2027 (estimated)
- Study completion31 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (13)Papers the sponsor has linked to this study.
- Other trials for Bleeding After GI EndoscopyStudies of the same condition, open and under way.
- More trials run by National Cheng-Kung University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- After allocation, prophylactic clips will be placed on the polypectomy wounds of patients in the Clipping group. In contrast, 3 g of sucralfate powder will be sprayed on the polypectomy wounds of patients in the Sucralfate group. The powder spray aimed for the full coverage of the polypectomy wound. Six sucralfate tablets (500 mg per Weizip tablet; Yung Shin Pharmaceutical Industries, Taichung, Taiwan) were ground to collect 3 g of sucralfate powder. This powder was then delivered through a functional powder delivery system (7F polyethylene catheter in connection by an oxygen cannula to the air source; propelling power: 1 L/min airflow from the hospital's air source, oxygen or CO2)
- Masking
- None (open label)
- Enrolment
- 160 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Cheng-Kung University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hsueh-Chien Chiang, National Cheng-Kung University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07257926
- Sponsor's protocol ID
- A-BR-114-027
- Status last verified
- Oct 2025
- First submitted
- 9 Oct 2025
- Last updated
- 2 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: after publication
Publications
Chiang HC, Chen PJ, Yang EH, Kuo TL, Hsieh MT, Kang JW, Cheng HC, Chang WL, Chen WY, Chiu HC, Lin MY, Hong TC, Chiang CM, Chen WC, Huang KK, Lu MH, Wu MH, Chen CY, Lin XZ, Chuang CH. Clinical Trial: Precise Administration of Sucralfate Powder in Prevention of Delayed Postpolypectomy Bleeding. A Randomized Controlled Trial. Clin Transl Gastroenterol. 2025 Apr 1;16(4):e00818. doi: 10.14309/ctg.0000000000000818.
PubMed 39836033Chiang HC, Chen PJ, Yang EH, Hsieh MT, Shih IC, Cheng HC, Chang WL, Chen WY, Chiu HC, Kuo HY, Tsai WC, Lo YN, Yang KC, Chiang CM, Chen WC, Huang KK, Tseng HH, Chen CY, Lin XZ, Chuang CH. Precise application of topical tranexamic acid to enhance endoscopic hemostasis for peptic ulcer bleeding: a randomized controlled study (with video). Gastrointest Endosc. 2023 Nov;98(5):755-764. doi: 10.1016/j.gie.2023.06.013. Epub 2023 Jun 24.
PubMed 37356632Ye Z, Reintam Blaser A, Lytvyn L, Wang Y, Guyatt GH, Mikita JS, Roberts J, Agoritsas T, Bertschy S, Boroli F, Camsooksai J, Du B, Heen AF, Lu J, Mella JM, Vandvik PO, Wise R, Zheng Y, Liu L, Siemieniuk RAC. Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline. BMJ. 2020 Jan 6;368:l6722. doi: 10.1136/bmj.l6722.
PubMed 31907223Wang Y, Ye Z, Ge L, Siemieniuk RAC, Wang X, Wang Y, Hou L, Ma Z, Agoritsas T, Vandvik PO, Perner A, Moller MH, Guyatt GH, Liu L. Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: systematic review and network meta-analysis. BMJ. 2020 Jan 6;368:l6744. doi: 10.1136/bmj.l6744.
PubMed 31907166Gutta A, Gromski MA. Endoscopic Management of Post-Polypectomy Bleeding. Clin Endosc. 2020 May;53(3):302-310. doi: 10.5946/ce.2019.062. Epub 2019 Sep 17.
PubMed 31525836Buddingh KT, Herngreen T, Haringsma J, van der Zwet WC, Vleggaar FP, Breumelhof R, Ter Borg F. Location in the right hemi-colon is an independent risk factor for delayed post-polypectomy hemorrhage: a multi-center case-control study. Am J Gastroenterol. 2011 Jun;106(6):1119-24. doi: 10.1038/ajg.2010.507. Epub 2011 Jan 25.
PubMed 21266961Elliott TR, Tsiamoulos ZP, Thomas-Gibson S, Suzuki N, Bourikas LA, Hart A, Bassett P, Saunders BP. Factors associated with delayed bleeding after resection of large nonpedunculated colorectal polyps. Endoscopy. 2018 Aug;50(8):790-799. doi: 10.1055/a-0577-3206. Epub 2018 Apr 6.
PubMed 29625506Bendall O, James J, Pawlak KM, Ishaq S, Tau JA, Suzuki N, Bollipo S, Siau K. Delayed Bleeding After Endoscopic Resection of Colorectal Polyps: Identifying High-Risk Patients. Clin Exp Gastroenterol. 2021 Dec 24;14:477-492. doi: 10.2147/CEG.S282699. eCollection 2021.
PubMed 34992406Rabeneck L, Paszat LF, Hilsden RJ, Saskin R, Leddin D, Grunfeld E, Wai E, Goldwasser M, Sutradhar R, Stukel TA. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology. 2008 Dec;135(6):1899-1906, 1906.e1. doi: 10.1053/j.gastro.2008.08.058. Epub 2008 Sep 13.
PubMed 18938166Kim HS, Kim TI, Kim WH, Kim YH, Kim HJ, Yang SK, Myung SJ, Byeon JS, Lee MS, Chung IK, Jung SA, Jeen YT, Choi JH, Choi KY, Choi H, Han DS, Song JS. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol. 2006 Jun;101(6):1333-41. doi: 10.1111/j.1572-0241.2006.00638.x.
PubMed 16771958Ferlitsch M, Moss A, Hassan C, Bhandari P, Dumonceau JM, Paspatis G, Jover R, Langner C, Bronzwaer M, Nalankilli K, Fockens P, Hazzan R, Gralnek IM, Gschwantler M, Waldmann E, Jeschek P, Penz D, Heresbach D, Moons L, Lemmers A, Paraskeva K, Pohl J, Ponchon T, Regula J, Repici A, Rutter MD, Burgess NG, Bourke MJ. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2017 Mar;49(3):270-297. doi: 10.1055/s-0043-102569. Epub 2017 Feb 17.
PubMed 28212588Hsu WF, Chang CY, Chang CC, Chang LC, Chen CH, Lin CC, Lin YM, Lee CL, Wu HY, Lee HC, Lee YC, Su MY, Lin LJ, Chia SL, Wu MS, Chiu HM; Colonoscopy Quality Assurance Joint Working Group of Taiwan Colorectal Cancer Screening Program and Digestive Endoscopy Society of Taiwan. Risk of colonoscopy-related complications in a fecal immunochemical test-based population colorectal cancer screening program. Endoscopy. 2022 Mar;54(3):290-298. doi: 10.1055/a-1328-5126. Epub 2021 Feb 24.
PubMed 33271603Zauber AG, Winawer SJ, O'Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012 Feb 23;366(8):687-96. doi: 10.1056/NEJMoa1100370.
PubMed 22356322
Study at a glance
From the registry record, last updated by the sponsor on 2 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prevention of Delayed Post-polypectomy Bleeding by Endoscopic Sucralfate Spray in High-risk Patients: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07257926
- Acronym / sponsor ID
- A-BR-114-027
- Conditions
- Bleeding After GI Endoscopy
- Keywords
- polypectomy, sucralfate, antiplatelet, anticoagulant, postpolypectomy bleeding
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 160 participants (estimated)
- Lead sponsor
- National Cheng-Kung University HospitalUniversity, hospital or other
- Study start
- 15 Dec 2025 (estimated)
- Primary completion
- 31 Dec 2027 (estimated)
- Study completion
- 31 Dec 2027 (estimated)
- First posted
- 2 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background： Colonoscopy can detect colon polyps and perform excision to the polyps to prevent colon cancer. However, delayed polypectomy bleeding is one of the complications to be noticed, which has an occurrence rate of about 1-2%, especially large polyps over 1cm with hot snare polypectomy. Colonoscopic clipping was applied for the treatment of bleeding. However, prophylactic clipping after polypectomy was not proved to reduce the rate of delayed polypectomy bleeding. Sucralfate is used for peptic ulcer treatment, which can become a protective layer on the wound to prevent environmental injury. Our preliminary data revealed the endoscopic sucralfate spray could reduce the delayed bleeding rate among general populations. Whether sucralfate can prevent polypectomy wounds from delayed bleeding in high-risk polyps is unknown.
Aim： This study aimed to compare the efficacy in reducing delayed bleeding rate between sucralfate administration and prophylactic clipping on high-risk polypectomy wounds.
Method： This is a randomized clinical trial. The study will recruit 160 patients. After randomization, 80 patients will be classified into the Sucralfate group and 80 into the Clipping group. The participants will receive an endoscopic survey as routine, and we will enroll all patients who take antiplatelets or anticoagulants with polyp size ≥ 1 cm after hot snare polyp excision. Exclusion criteria include patients with an allergy to sucralfate. If immediate polypectomy bleeding occurs, we will apply standard endoscopic therapy by either local injection of diluted epinephrine, heater probe coagulation, and/or hemoclipping. After then, we will spray 3g of sucralfate powder through colonoscopy precisely on the polypectomy wound in the Sucralfate group, and prophylactic clipping will be placed on the polypectomy wound in the Clipping group. All enrolled patients will be monitored for delayed bleeding for 28 days after the colonoscopy.
Expected results and clinical importance:
This study is expected to find that the use of sucralfate powder can more effectively reduce the bleeding risk in high-risk wounds compared to prophylactic clips. In addition to promoting the implementation of national health policies and reducing public exposure to the risk of complications, it can also help avoid medical expenses resulting from complications.
Detailed description
Colonoscopic polypectomy is a key procedure for prevention of colorectal cancer and reduction of associated mortality risk. However, this procedure carries a risk of postpolypectomy bleeding. Postoperative bleeding can occur immediately (intraoperatively, manageable during colonoscopy) or after a while (for example, a month after colonoscopy). The causes of delayed postpolypectomy bleeding include detachment of eschar due to stool passage and extension of submucosal necrosis due to hot snare polypectomy. The incidence rate of delayed postpolypectomy bleeding ranges from 1% to 2%; this rate increases to 6% in patients with large (> 2 cm) colon polyps. Risk factors for this complication include hot snare polypectomy, chronic kidney disease, liver cirrhosis, antiplatelet agent or anticoagulant use, and pedunculated colon polyps. Delayed postpolypectomy bleeding is a major complication that requires prompt management. Patients with delayed bleeding usually present with hematochezia, anemia, hemodynamic instability, or end-organ damage. Hemostasis often requires repeated colonoscopic procedures and hospitalization, which increases patient discomfort and treatment costs. In complex cases, emergent surgical intervention or transarterial embolization may become necessary. Therefore, the prevention of delayed postpolypectomy bleeding is crucial for both patients and clinicians.
Sucralfate, a basic aluminum salt of sucrose octa sulfate, has been used in the treatment of gastrointestinal ulcers; this powder accelerates healing and prevents bleeding. The mechanisms underlying its effects involve binding to exposed proteins on damaged cells and creating a protective layer that shields the mucosa from further injury. Sucralfate can also bind to growth factors and thus promote angiogenesis and mucosal healing. Pharmacodynamic insights have suggested that local application of sucralfate is more effective in promoting wound healing than systemic administration, likely because of its ability to locally adhere to damaged mucosa, forming a sticky coating that accelerates healing.
Liquid sucralfate has demonstrated healing efficacy in endoscopic mucosal resection-induced gastric ulcers. Rectosigmoid ulcer lesions can also be treated with topical sucralfate by enema. In radiation proctitis and idiopathic ulcerative proctitis, sucralfate enemas produced clinical and endoscopic improvement. Compared to the drug powder, we think the liquid formulation would soon drain away from the wound. Therefore, we assume that the local application of sucralfate powder to polypectomy wounds would effectively prevent delayed postpolypectomy bleeding.
In our preliminary data of a pilot study (IRB: A-BR-111-085, ClinicalTrials.gov ID: NCT05817656), a total of 160 patients with polyps (size≥0.5cm) who had undergone colonoscopic polypectomy were enrolled. divided into the sucralfate and control groups (80 per group). After polypectomy, the patients received standard treatment for immediate bleeding. Then, they were randomly allocated to either a sucralfate group (prophylactic spraying of 3g sucralfate powder on polypectomy wounds) or a control group. As a result, the rate of delayed postpolypectomy bleeding (0% vs 6.3%, respectively; P=0.029) and postpolypectomy overt bloody stool (2.4% vs 18.8%, respectively; P=0.001) were lower in the sucralfate group than in the control group. The duration of freedom from delayed bleeding was longer in the sucralfate group than in the control group (P=0.024). Colonoscopic spraying of sucralfate powder is a safe approach with potential to reduce the risk of delayed postpolypectomy bleeding among the general population.
However, whether this method can be applied to high-risk polyps were indetermined, such as large polyps > 1cm under hot snare polypectomy, especially in those who take antiplatelets or anticoagulants. Moreover, the prophylactic potency comparison between sucralfate spray and prophylactic clips was also unknown. Therefore, a head-to-head comparison between sucralfate powder and clipping is needed to identify the preventative potency.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- After allocation, prophylactic clips will be placed on the polypectomy wounds of patients in the Clipping group. In contrast, 3 g of sucralfate powder will be sprayed on the polypectomy wounds of patients in the Sucralfate group. The powder spray aimed for the full coverage of the polypectomy wound. Six sucralfate tablets (500 mg per Weizip tablet; Yung Shin Pharmaceutical Industries, Taichung, Taiwan) were ground to collect 3 g of sucralfate powder. This powder was then delivered through a functional powder delivery system (7F polyethylene catheter in connection by an oxygen cannula to the air source; propelling power: 1 L/min airflow from the hospital's air source, oxygen or CO2)
| Arm | Type | Receives |
|---|---|---|
| Clipping group | Active comparator | Device: ClipAfter identifying a resectable colon polyp (size ≥ 1 cm), the operator performed a hot polypectomy. Following hot polypectomy, the wound was observed for 30 seconds to detect potential immediate bleeding. Standard endoscopic interventions such as diluted epinephrine injection, heat coagulation, or clipping were promptly administered if immediate bleeding occurred. Subsequently, the patients were randomly assigned to either the Sucralfate or Clipping groups. After allocation, prophylactic clips will be placed on the polypectomy wounds of patients in the Clipping group. |
| Sucralfate group | Experimental | Drug: SucralfateAfter identifying a resectable colon polyp (size ≥ 1 cm), the operator performed a hot polypectomy. Following hot polypectomy, the wound was observed for 30 seconds to detect potential immediate bleeding. Standard endoscopic interventions such as diluted epinephrine injection, heat coagulation, or clipping were promptly administered if immediate bleeding occurred. Subsequently, the patients were randomly assigned to either the Sucralfate or Clipping groups. After allocation, 3 g of sucralfate powder will be sprayed on the polypectomy wounds of patients in the Sucralfate group. The powder spray aimed for the full coverage of the polypectomy wound. Six sucralfate tablets (500 mg per Weizip tablet; Yung Shin Pharmaceutical Industries, Taichung, Taiwan) were ground to collect 3 g of sucralfate powder. This powder was then delivered through a functional powder delivery system (7F polyethylene catheter in connection by an oxygen cannula to the air source; propelling power: 1 L/min airflow) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- patients who take antiplatelets or anticoagulants with large polyps (size ≥ 1 cm)
Key exclusion criteria (3 listed)
- lacked complete data (serum creatinine, platelet count, and prothrombin time) pertaining to the previous 6 months
- those who did not discontinue or inadequately discontinued antiplatelet agents or anticoagulants
- those who had a known allergy to sucralfate
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Sucralfate3 g of sucralfate powder will be sprayed on the polypectomy wounds of patients in the Sucralfate group. | Drug | Sucralfate group |
| ClipProphylactic clips will be placed on the polypectomy wounds of patients in the Clipping group | Device | Clipping group |
Primary outcome
Rate of delayed postpolypectomy bleeding
Time frame: 28 days
Delayed postpolypectomy bleeding was defined as the need for reintervention or hospitalization, indicating a clinically significant bleeding event
2 secondary outcomes
Rate of overt bloody stool
Time frame: 2 days
Rate of severe bleeding from polypectomy wounds
Time frame: 28 days
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Dec 2025.
- Results publication: PubMed 39836033Chiang HC, Chen PJ, Yang EH, Kuo TL, Hsieh MT, Kang JW, Cheng HC, Chang WL, Chen WY, Chiu HC, Lin MY, Hong TC, Chiang CM, Chen WC, Huang KK, Lu MH, Wu MH, Chen CY, Lin XZ, Chuang CH. Clinical Trial: Precise Administration of Sucralfate Powder in Prevention of Delayed Postpolypectomy Bleeding. A Randomized Controlled Trial. Clin Transl Gastroenterol. 2025 Apr 1;16(4):e00818. doi: 10.14309/ctg.0000000000000818.
- Results publication: PubMed 37356632Chiang HC, Chen PJ, Yang EH, Hsieh MT, Shih IC, Cheng HC, Chang WL, Chen WY, Chiu HC, Kuo HY, Tsai WC, Lo YN, Yang KC, Chiang CM, Chen WC, Huang KK, Tseng HH, Chen CY, Lin XZ, Chuang CH. Precise application of topical tranexamic acid to enhance endoscopic hemostasis for peptic ulcer bleeding: a randomized controlled study (with video). Gastrointest Endosc. 2023 Nov;98(5):755-764. doi: 10.1016/j.gie.2023.06.013. Epub 2023 Jun 24.
- Results publication: PubMed 31907223Ye Z, Reintam Blaser A, Lytvyn L, Wang Y, Guyatt GH, Mikita JS, Roberts J, Agoritsas T, Bertschy S, Boroli F, Camsooksai J, Du B, Heen AF, Lu J, Mella JM, Vandvik PO, Wise R, Zheng Y, Liu L, Siemieniuk RAC. Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline. BMJ. 2020 Jan 6;368:l6722. doi: 10.1136/bmj.l6722.
- Results publication: PubMed 31907166Wang Y, Ye Z, Ge L, Siemieniuk RAC, Wang X, Wang Y, Hou L, Ma Z, Agoritsas T, Vandvik PO, Perner A, Moller MH, Guyatt GH, Liu L. Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: systematic review and network meta-analysis. BMJ. 2020 Jan 6;368:l6744. doi: 10.1136/bmj.l6744.
- Results publication: PubMed 31525836Gutta A, Gromski MA. Endoscopic Management of Post-Polypectomy Bleeding. Clin Endosc. 2020 May;53(3):302-310. doi: 10.5946/ce.2019.062. Epub 2019 Sep 17.
- Results publication: PubMed 21266961Buddingh KT, Herngreen T, Haringsma J, van der Zwet WC, Vleggaar FP, Breumelhof R, Ter Borg F. Location in the right hemi-colon is an independent risk factor for delayed post-polypectomy hemorrhage: a multi-center case-control study. Am J Gastroenterol. 2011 Jun;106(6):1119-24. doi: 10.1038/ajg.2010.507. Epub 2011 Jan 25.
- Results publication: PubMed 29625506Elliott TR, Tsiamoulos ZP, Thomas-Gibson S, Suzuki N, Bourikas LA, Hart A, Bassett P, Saunders BP. Factors associated with delayed bleeding after resection of large nonpedunculated colorectal polyps. Endoscopy. 2018 Aug;50(8):790-799. doi: 10.1055/a-0577-3206. Epub 2018 Apr 6.
- Results publication: PubMed 34992406Bendall O, James J, Pawlak KM, Ishaq S, Tau JA, Suzuki N, Bollipo S, Siau K. Delayed Bleeding After Endoscopic Resection of Colorectal Polyps: Identifying High-Risk Patients. Clin Exp Gastroenterol. 2021 Dec 24;14:477-492. doi: 10.2147/CEG.S282699. eCollection 2021.
- Results publication: PubMed 18938166Rabeneck L, Paszat LF, Hilsden RJ, Saskin R, Leddin D, Grunfeld E, Wai E, Goldwasser M, Sutradhar R, Stukel TA. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology. 2008 Dec;135(6):1899-1906, 1906.e1. doi: 10.1053/j.gastro.2008.08.058. Epub 2008 Sep 13.
- Results publication: PubMed 16771958Kim HS, Kim TI, Kim WH, Kim YH, Kim HJ, Yang SK, Myung SJ, Byeon JS, Lee MS, Chung IK, Jung SA, Jeen YT, Choi JH, Choi KY, Choi H, Han DS, Song JS. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol. 2006 Jun;101(6):1333-41. doi: 10.1111/j.1572-0241.2006.00638.x.
- Results publication: PubMed 28212588Ferlitsch M, Moss A, Hassan C, Bhandari P, Dumonceau JM, Paspatis G, Jover R, Langner C, Bronzwaer M, Nalankilli K, Fockens P, Hazzan R, Gralnek IM, Gschwantler M, Waldmann E, Jeschek P, Penz D, Heresbach D, Moons L, Lemmers A, Paraskeva K, Pohl J, Ponchon T, Regula J, Repici A, Rutter MD, Burgess NG, Bourke MJ. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2017 Mar;49(3):270-297. doi: 10.1055/s-0043-102569. Epub 2017 Feb 17.
- Results publication: PubMed 33271603Hsu WF, Chang CY, Chang CC, Chang LC, Chen CH, Lin CC, Lin YM, Lee CL, Wu HY, Lee HC, Lee YC, Su MY, Lin LJ, Chia SL, Wu MS, Chiu HM; Colonoscopy Quality Assurance Joint Working Group of Taiwan Colorectal Cancer Screening Program and Digestive Endoscopy Society of Taiwan. Risk of colonoscopy-related complications in a fecal immunochemical test-based population colorectal cancer screening program. Endoscopy. 2022 Mar;54(3):290-298. doi: 10.1055/a-1328-5126. Epub 2021 Feb 24.
- Individual participant dataSharing planned: Yes. after publication
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Sucralfate and Clip in people with Bleeding After GI Endoscopy, run by National Cheng-Kung University Hospital.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 2 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Hsueh-Chien Chiang, MD (+88662353535, scion456scion@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Rate of delayed postpolypectomy bleeding (time frame: 28 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07257926, which also lists 13 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Dec 2025.