Risk factors for colonoscopic perforation: A population-based study of 80118 cases

Hamdani, Uzair; Raza, Naeem; Haider, Fyeza; Bansal, Pardeep; Komar, Michael; Diehl, David L.; Kirchner, H. Lester

doi:10.3748/wjg.v19.i23.3596

Cited by 69 publications

(53 citation statements)

References 21 publications

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“…Fourteen studies were retrospective ( 4,7,8,(10)(11)(12)14,15,17,19,21,22,24,25 ) and seven were prospective studies ( 5,6,9,13,16,18,20 ). Th ere were four studies from the United States ( 5,12,17,22 ), three from Canada ( 15,20,21 ), ten from Europe (6)(7)(8)(9)(10)(11)13,16,18,19 ), three from South-Korea ( 14,24,25 ), and one from New Zealand ( 4 ). Mean age of the study populations varied from 50.4 to 70.0 years ( 4,6,10,14-21,24,25 ) (median age, 57 to 75 years ( 5,9,13,16,21 )); 51.5% were males (4)(5)(6)…”

Section: Resultsmentioning

confidence: 97%

“…Post-colonoscopy "perforation" rate ranges from 0 to 1.7/1,000 colonoscopies (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23), post-colonoscopy "bleeding" rate from 0 to 22.3/1,000 colonoscopies ( 4-11,13-18, 20-22,24,25 ), and "mortality" rate from 0 to 2.0/1,000 colonoscopies (4)(5)(6)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)25 ). In screening populations, an overall postcolonoscopy complication rate of 2.8/1,000 procedures has been reported ( 26 ).…”

Section: Introductionmentioning

confidence: 99%

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Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies

Reumkens

Rondagh

Bakker

et al. 2016

American Journal of Gastroenterology

292

245

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Section: Resultsmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies

Reumkens

Rondagh

Bakker

et al. 2016

American Journal of Gastroenterology

292

245

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“…Previous studies have shown that patients over 65 years of age present significant risks for perforation (1,(21)(22)(23). In some studies, it has been reported that the perforation rate in patients over 75 years of age can increase by four to six times compared to that in young patients (24,25 (24) observed that the perforation rate is higher in patients with two or more comorbidities.…”

Section: Discussionmentioning

confidence: 94%

“…In our study, increased risk of colonic perforation was observed in patients with ASA scores greater than 3. Handami et al (21) reported older age, female gender, low BMI, co-existent diseases, and low albumen levels as risk factors of increased perforation rates in hospitalized patients, especially among those admitted to the intensive care unit. In terms of indications, perforation rates have been found to be higher during procedures performed for diagnosing abdominal pain, anemia, Crohn's disease, and bleeding (21).…”

Section: Discussionmentioning

confidence: 99%

Colonoscopic perforations: Single center experience and review of the literature

Çolak¹,

Gürbulak²,

Bektaş³

et al. 2017

Turk J Surg

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Colonoscopic perforations: Single center experience and review of the literature INTRODUCTION Colonoscopy is accepted as the gold standard imaging modality for the diagnosis of colon and distal ileum diseases. It aids the detection of smaller lesions and tissue sampling and also functions as a therapeutic procedure for intestinal diseases. Similar to other invasive procedures, colonoscopy has been associated with various complications; among these, perforation is the most important. Iatrogenic colonic perforation has high rates of mortality and morbidity. It is mainly divided into two categories: diagnostic and therapeutic (1, 2). Management includes both medical and surgical approaches. However, the best approach for treatment depends on various factors, such as the patient's general condition, age, comorbidities, and, most importantly, the time between the onset and diagnosis of perforation. In this study, we aimed to evaluate the incidence of perforation in a large colonoscopy series, discuss patient management strategies, and analyze the clinical consequences of iatrogenic colonic perforation. MATERIAL AND METHODSBetween January 2005 and May 2015, a total of 31,655 lower GIS endoscopies were performed at our center. Patients with iatrogenic colonic perforations were investigated retrospectively. All procedures were conducted under sedoanalgesia. The procedures were performed by 27 endoscopists, including 24 general surgeons and 3 gastroenterology specialists. The experience of the endoscopists varied between 2 and 15 years.We analyzed the demographic characteristics of the patients, the type of procedure (therapeutic or diagnostic), indications for colonoscopy and associated colonic disease, location and detection time of perforation, management strategy (operative or nonoperative), and complications.The perforations were detected either during colonoscopy by observing a visible defect in the colonic wall (mesenteric or antimesenteric side) or after the procedure by detecting free intra-abdominal air upon radiological examination. Patients who complained of abdominal pain or distention following 195Objective: Iatrogenic colonic perforation is a well-known complication that can increase mortality and morbidity in patients undergoing colonoscopy. Closer follow-up and a well-planned treatment strategy are required when perforation arises as a complication. The aims of this study are to (1) report our experience with a large colonoscopy series; (2) evaluate the underlying mechanisms of iatrogenic colonic perforation; (3) discuss the ideal period between onset and treatment; and (4) review the current literature regarding the management of iatrogenic colonic perforations. Material and Methods:Patients who underwent colonoscopy between January 2005 and May 2015 at a single center were reviewed retrospectively. Procedures during which colonic perforations occurred were documented and analyzed.Results: Between January 2005 and May 2015, 31,655 patients underwent colonoscopy and 5,214 patients underwent recto-sigmoi...

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“…In a large study in 2013 performed by Hamadani et al risk of colon perforation was about 1% in all colonoscopic studies (18). With the aid of a laparoscopic endoscopic hybrid approach, any full thickness colon wall injury due to thermal injuries, barotrauma or endoscope itself will be diagnosed properly and repaired if needed.…”

Section: Complicationsmentioning

confidence: 99%

Combined Endoscopic Laparoscopic Surgery (CELS): A Mini Review

Solouki

Khalaj

Pazouki

2017

J Minim Invasive Surg Sci

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Colon polyps are a relatively common problem which necessitates a colonoscopic polypectomy. It has its own limitations in surgery. Sessile or large polyps or those at unavailable section (ie: in mesenteric border of colon) are not suitable for a colonoscopic approach for excision. Furthermore, in colonoscopic resection, there is a frustrating risk of a colon wall perforation that not diagnosed intraoperatively. By the help of Combined Endoscopic Laparoscopic Surgery (CELS), a more aggressive polypectomy could be done while the colon wall monitored intraoperatively via laparoscopy and there is an appropriate possibility of colon wall repair if any perforation had occurred .This is a new method in diagnostic and curative surgical approaching to nonmalignant colon lesion that needs a coherent cooperation between laparoscopy and colonoscopy for performing a safe colonoscopic polypectomy.

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Risk factors for colonoscopic perforation: A population-based study of 80118 cases

Cited by 69 publications

References 21 publications

Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies

Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies

Colonoscopic perforations: Single center experience and review of the literature

Combined Endoscopic Laparoscopic Surgery (CELS): A Mini Review

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