Iatrogenic Colonic Perforation

Miranda, L.; Settembre, A.; Piccolboni, D.; Capasso, Pietro; Corcione, Francesco

doi:10.1097/sle.0b013e318219a2cf

Cited by 21 publications

(16 citation statements)

References 23 publications

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“…Endoscopic clipping to close a perforation has been suggested for small (10 mm) perforations. This procedure must be done immediately, and thus, endoscopic repair is used only if the endoscopist finds the perforation during colonoscopy [5,20]. In the present study, three patients underwent endoscopic clipping; one patient underwent laparoscopic treatment and the other two patients underwent laparotomy.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, the sigmoid colon was also the main perforation site, and accounted for 15 of the 25 patients. Perforations arise via three principal mechanisms, that is, mechanical injury, barotrauma, and thermal injuries during therapeutic colonoscopy [5,6,7,11,15,16,17]. Mechanical injuries are the most common cause, and perforations can arise due to forceful instrument insertion, moving the colonoscope towards the mucosal surface without direct view.…”

Section: Discussionmentioning

confidence: 99%

“…Frequencies of perforation are higher after polypectomies, biopsies, and the excessive use of electrocautery. Thermal injuries are associated with the smallest perforations, and thus, are usually detected at a later stage [5,13,16]. …”

Section: Discussionmentioning

confidence: 99%

“…Prospective study is difficult because of the rarity of perforations caused by colonoscopy [8]. Thus, the optimal treatment of perforation should be determined based on considerations of the mechanism, location, and size of perforation, symptom severity, time to surgery after perforation, concomitant disease, and patient status [1,5,10,16]. In the present study, we decided on the type of operation based on considerations of physical status on a case-by-case basis.…”

Section: Discussionmentioning

confidence: 99%

“…In the past, colonic perforation after colonic perforation was managed by explorative laparotomy with primary perforation closure or bowel resection [4,5]. However, during the last decade, laparoscopic surgery has been accepted to be a safe surgical modality [6,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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PurposeColonoscopy is a safe and commonly used method for the screening of colon cancer, but sometimes major complications, such as, colonic perforation or hemorrhage occur during the procedure. The aim of this study was to compare the surgical outcomes of laparoscopic and open surgery for colon perforation after colonoscopy.MethodsA retrospective review of patient records was performed on 25 patients with iatrogenic colon perforation during colonoscopy during the 7-year period from January 2005 to June 2012. Demographic data, operative procedures, operation times, postoperative complications, hospital course, and morbidities in the laparoscopic surgery group (LG) and open surgery group (OG) were compared.ResultsSeventeen of the 25 patients underwent laparoscopic surgery (68%) and 8 patients open surgery (32%). The most common surgical methods were primary repair in the LG, and Hartmann's operation in the OG. Average time to first flatus was 2.9 days in the LG and 4.5 days in the OG, and average times to first meals were 4.5 days and 5 days, respectively. Mean hospital stays were 10.8 days in the LG and 17 days in the OG. After surgery, complications occurred in two patients in the LG, but no complication occurred in the OG.ConclusionLaparoscopic repair for iatrogenic colonic perforation during colonoscopy seems to be useful and safe surgical method in early period after perforation. However, open surgery is also needed for the delayed cases after perforation.

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Section: Discussionmentioning

confidence: 99%