Comparison of the surgical outcomes of laparoscopic versus open surgery for colon perforation during colonoscopy

Kim, Jeongsoo; Lee, Gil Jae; Baek, Jeong‐Heum; Lee, Won Suk

doi:10.4174/astr.2014.87.3.139

Cited by 22 publications

(26 citation statements)

References 19 publications

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“…Other studies by Rothold et al [ 125 ] and Schloricke et al [ 127 ] also observed fewer postoperative complications and significantly shorter hospital stays when utilizing the laparoscopic approach. Similar studies with similar results were published by Coimbra et al [ 124 ] and Kim et al [ 128 ], although in these studies, delayed surgeries (> 24 h) and ostomy formation rates were more frequently observed in the open groups, with higher primary repair rates in the laparoscopic groups.…”

Section: Resultssupporting

confidence: 89%

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

de’Angelis

Saverio²,

Chiara

et al. 2018

World J Emerg Surg

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Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45–60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator’s level of experience, and surgical device availability.Although ICPs have been the focus of numerous publications, no guidelines have been created to standardize the management of ICPs. The aim of this article is to present the World Society of Emergency Surgery (WSES) guidelines for the management of ICP, which are intended to be used as a tool to promote global standards of care in case of ICP. These guidelines are not meant to substitute providers’ clinical judgment for individual patients, and they may need to be modified based on the medical team’s level of experience and the availability of local resources.

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Section: Resultssupporting

confidence: 89%

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

de’Angelis

Saverio²,

Chiara

et al. 2018

World J Emerg Surg

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show abstract

“…Especially, when the colonic perforation occurs during a colonoscopy, the bowel content in the colon is minimal because of the bowel preparation, and colonic tissue is generally healthy. Therefore, laparoscopic primary repair or even conservative treatment can be considered [ 7 ]. As in the case of colonoscopy-induced colon perforation, in the case of ARM-induced colon perforation, if spillage of bowel content is minimal and the perforation occurs in the mesenteric space, the subsequent symptoms of the patient are usually tolerable, so primary repair or conservative treatment can be considered.…”

Section: Discussionmentioning

confidence: 99%

Colorectal Perforation After Anorectal Manometry for Low Anterior Resection Syndrome

2017

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We experienced 3 cases of manometry-induced colon perforation. A 75-year-old man (case 1) underwent anorectal manometry (ARM) 3 years after radiotherapy for prostate cancer and a laparoscopic intersphincteric resection for rectal cancer. A 70-year-old man (case 2) underwent ARM 3 months after conventional neoadjuvant chemoradiotherapy and a laparoscopic low anterior resection for rectal cancer. A 78-year-old man (case 3) underwent ARM 2 months after a laparoscopic intersphincteric resection for rectal cancer. In all cases, a colon perforation with fecal peritonitis occurred. All were treated successfully using prompt and active operations and were discharged without any complications. ARM with a balloon, as a measure of rectal compliance, should be performed 2 months or longer after surgery. If a perforation occurs, prompt and active surgical intervention is necessary due to the high possibility of extensive fecal peritonitis.

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“…Laparoscopy emerged in the last decade as a therapeutic possibility in early-detected perforations including those with endoscopic failure, because of its many advantages: less postoperative complications, shorter lengths of hospital stay, smaller incision size and lower labor withdrawal time. 19 However, this technique was only adopted in the latest 2 patients in this series. The areas of perforation were easily localized and there was not extensive inflammation neither fecal contamination.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Perforations During Colonoscopy In a Portuguese Population: A Study Including In and Out-Of-Hospital Procedures

Campos

Amaro

Portela

et al. 2016

GE Portuguese Journal of Gastroenterology

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IntroductionThe risk of iatrogenic perforations in colonoscopy is not negligible. Experience with endoscopic closure of perforations is increasing and new devices for this purpose are being released, making endoscopy a therapeutic option. National data regarding iatrogenic perforations is scarce and the burden of iatrogenic perforations in out-hospital procedures is poorly characterized in the literature.ObjectiveEvaluation of iatrogenic perforations rate during colonoscopy, their characteristics, management and prognosis.MethodsRetrospective study of all patients with perforations secondary to in-hospital and non-hospital colonoscopies treated in a tertiary hospital between 01-01-2006 and 01-10-2014. Demographic, endoscopic, radiological and therapeutic data were analyzed.ResultsFifty-three perforations were identified, 20 occurring in colonoscopies performed in non-hospital environment (45% with therapeutic procedures) and 33 occurring in-hospital procedures (73% in therapeutic colonoscopies; representing 0.12% of all colonoscopies carried out in-hospital). Patients: male in 56%, average age of 71 years, history of previous abdominopelvic surgery in 31% and diverticulosis in 10%. Colonoscopy: elective in 93%, under deep sedation in 21%, with less than excellent/good bowel preparation in 56%. A resident was the first performer in 10 cases. Perforations: average size of 21 mm (4–130 mm), diagnosed during the procedure in 51% of cases and occurred in rectum-sigmoid transition in 58.5%. Regarding therapeutics, all patients with perforation occurring in non-hospital colonoscopies were managed by surgery. Concerning treatment of those in our unit: 2-conservative, 12-endoscopic (10 successfully), 21-surgical (including the 2 cases with failure of the endoscopic approach). Comparing endoscopic treatment (n = 10, G1) versus surgery (n = 21; G2): perforation size – 9 mm (G1) versus 28 mm (G2); perforation location – 7/10 in rectum-sigmoid (G1) versus 8/21 in rectum-sigmoid and 10/21 transverse/ascending colon/hepatic angle (G2). Morbidity: 1 infection in G1 and 13 complications in G2 (infection, hemorrhage, fistula). Mortality: no deaths in G1 and 2 deaths at 30 days due to septic shock in G2.ConclusionPerforations in colonoscopy are rare in our clinical practice. Endoscopic closure was effective, though limited to perforations found during the procedure. The mortality was relatively low and endoscopic management did not seem to worsen it. An additional effort is necessary in order to detect perforations during colonoscopy.

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Comparison of the surgical outcomes of laparoscopic versus open surgery for colon perforation during colonoscopy

Cited by 22 publications

References 19 publications

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

Colorectal Perforation After Anorectal Manometry for Low Anterior Resection Syndrome

Iatrogenic Perforations During Colonoscopy In a Portuguese Population: A Study Including In and Out-Of-Hospital Procedures

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