Eight RCTs (2,595 polyps) were included in the review. Quality scores ranged from 7 to 10 out of 10. Gaps in reporting of randomisation, allocation concealment methods and blinding were present in several studies.
Early bleeding rate was significantly lower for those who received monotherapy compared to control (OR 0.34, 95% CI 0.20 to 0.58; four trials), and for those who received epinephrine-saline injection compared to control (OR 0.37, 95% CI 0.22 to 0.64; four trials). Combined therapy was significantly more effective than the use of a single technique (OR 0.12, 95% CI 0.03 to 0.47; two trials). Endloop techniques were more effective than epinephrine-saline injection or control (OR 0.25, 95% CI 0.11 to 0.58; three trials). There was no evidence of heterogeneity in the analyses (Ι²=0%).
No significant differences in late bleeding rates were observed between monotherapy and control, between epinephrine-saline injection and control, or between combined and single therapy. No significant differences were found between endoloop and epinephrine-saline injection or control, or between endoclips and epinephrine-saline injection or control. There was no evidence of heterogeneity in the analyses (Ι²=0%).