Outcomes of surgical management of iatrogenic colonic perforation by colonoscopy and risk factors for worse outcome

J BUON. 2019 Mar-Apr;24(2):431-435.

Abstract

Purpose: To assess outcomes of surgical management for iatrogenic colonic perforations and risk factors of worse outcome.

Methods: We reviewed the medical records of patients with colonic perforations during colonoscopies 2007 - 2016 at the National Cancer Institute. We collected patient demographic data, colonoscopic reports, perforations treatment and outcome.

Results: Perforation rate was 0.14% (23 of 16 186). Twenty were managed surgically. The most common location of perforation was the sigmoid colon in 12 cases (60%). The most used surgical technique was simple suture (11 cases - 55%), followed by resection with anastomosis (6 - 30%), and Hartman's procedure in 3 cases (15%). Postoperative morbidity and mortality rates were 45% and 15% - three patients died. No significant relationship between time to surgery (p=0.285), American Society of Anaesthesiologists (ASA) score (p=0.642) or patient age (p=0.964) and postoperative complication were found.

Conclusions: Patients need to be informed of the complications of colonoscopy. We could not determine strong risk factors for worse outcomes.

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Colon / pathology
  • Colon / surgery
  • Colonic Diseases / diagnosis
  • Colonic Diseases / etiology
  • Colonic Diseases / pathology*
  • Colonic Diseases / surgery
  • Colonoscopy / adverse effects*
  • Female
  • Humans
  • Iatrogenic Disease / epidemiology*
  • Iatrogenic Disease / prevention & control
  • Intestinal Perforation / epidemiology
  • Intestinal Perforation / pathology
  • Intestinal Perforation / surgery
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / pathology
  • Risk Factors