Response

摘要

I appreciate the comments from Burgess et al regarding our study of prophylactic clip closure and its effect on delayed postpolypectomy hemorrhage.Burgess et al point out that we could not clip some of the polyp sites because of large size or difficulty approaching the lesions. Such lesions were included in the undipped or partially clipped groups. However, in a multi-variable analysis that accounted for size, clipping was still associated with a substantially decreased risk of bleeding. We agree that large circular defects may be difficult to clip; however, some defects with diameters much larger than the clip diameter can be closed by a zippering process, in which placement of a clip along 1 end of the defect brings the adjacent portion of the defect closer together, so that the next clip can effectively span the edges of the defect (Figs. 1 and 2).