Using DOACs can considerably increase the risk of postpolypectomy bleeding, even with 24-hour withdrawal prior to polypectomy. Compared to Warfarin, Dabigatran exhibits a reduced risk of  postpolypectomy bleeding.

In people exposed to direct oral anticoagulants (DOACs), the risk of postpolypectomy bleeding (PPB)  was explored.

Using the search phrases “(Nonvitamin K antagonist oral anticoagulants or NOAC or Apixaban or Dabigatran or Rivaroxaban or Edoxaban or DOAC or Direct oral anticoagulants) and polypectomy," a comprehensive search was carried out in the databases like PubMed, Embase, and the Cochrane Library. In this systematic review and meta-analysis, the identification of studies examining the link between DOACs and PPB was done.

Overall, 103 studies were recognized using the bibliographical search. Final inclusions comprised 12 research with 621,279 volunteers (eleven cohort studies, of which one was a randomized controlled trial and ten were retrospective studies). Combined estimations illustrated that people taking DOACs had a greater risk of PPB than those not taking anticoagulation (odds ratio [OR]: 6.170).

The same outcome was obtained when DOACs were discontinued 24 hours prior to polypectomy (OR: 8.66). Warfarin and DOACs did not significantly differ generally (OR 0.826). Compared to Warfarin, Dabigatran had a lower PPB rate in subgroups (OR: 0.582).

For PPB, DOACs were independent risk factors, even with 24-hour withdrawal prior to polypectomy. Furthermore, the superiority of Dabigatran over Warfarin for use in polypectomy was reported.