Outcome of surgery for colonoscopic perforation
Article first published online: 5 MAR 2012
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Volume 14, Issue 4, pages e187–e190, April 2012
How to Cite
van der Sluis, F. J., Loffeld, R. J. and Engel, A. F. (2012), Outcome of surgery for colonoscopic perforation. Colorectal Disease, 14: e187–e190. doi: 10.1111/j.1463-1318.2011.02841.x
- Issue published online: 5 MAR 2012
- Article first published online: 5 MAR 2012
- Accepted manuscript online: 28 SEP 2011 11:29AM EST
- Received 7 April 2011; accepted 25 August 2011; Accepted Article online 28 September 2011
- colonoscopic perforation;
- surgical outcome;
- risk factors
Aim The aetiology of colonoscopic perforation and factors related to poor outcome of surgical treatment were studied.
Method A single-centre review was conducted of all patients who underwent surgical treatment of a colonoscopic perforation, identified from a prospective registry of 21 981 consecutive colonoscopies carried out between 1993 and 2009.
Results There were 29 (eight women) patients of mean age 73 years including 10 who had a nonelective colonoscopy. The perforation was not immediately recognized in 12 patients and in the remaining 17, seven were initially managed conservatively. The causes of perforation were barotrauma (11), mechanical force (14) and polypectomy-related (3). Barotrauma was more frequent in emergency colonoscopy and mechanical force in elective colonoscopy. The outcome of surgery was as follows: mortality 10%, complications 34.5%, reoperation 14%, secondary surgery 23% and permanent colostomy 3%. The only factor related to in-hospital mortality was an increased American Society of Anesthesiologists (ASA) score.
Conclusion Colonoscopic perforation requiring surgery is a catastrophic event with high mortality, morbidity and reoperation rates.