Abstract
Purpose
Colonoscopy is currently a standard and widespread technique used in screening for colorectal cancer. Iatrogenic colonic perforation during colonoscopy is an unfortunate complication that can induce significant morbidity and even death. Here, we reviewed the clinical results of iatrogenic colonoscopic perforation in our hospital.
Methods
This was a retrospective review of 35,186 colonoscopies performed in the Tri-Service General Hospital, Taipei, Taiwan from January 1998 to December 2007. Patient demographic data, indications, comorbidities, operative history, perforation site, time of diagnosis, management, complications, hospital stay, and outcomes were recorded.
Results
In this 10-year period, 23 cases of iatrogenic colonic perforation were recorded (0.065%) affecting 11 men and 12 women. The mean age was 71.2 years. There were 13 patients in American Society of Anesthesiology (ASA) classifications 1 or 2 (low anesthetic risk, group A), and ten patients in ASA classes 3 or 4 (high anesthetic risk, group B). The mean hospital stay was 12 days in group A versus 23.5 days in group B (P = 0.002). Moreover, four patients in group B died (17%; P = 0.024).
Conclusion
Colonoscopy-related perforation can progress to peritonitis and sepsis, resulting in serious morbidity or death. High-anesthetic risk patients with colonic perforation have a longer hospital stay and a poor prognosis. Hence, patients need to be informed of the complications of colonoscopy, and clinicians must be cautioned about the potential problems for patients with a high-anesthetic risk when performing the procedure.
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This article has no support of commercial associations (e.g., consultancies, stock ownership, equity interests, patent-licensing arrangements, etc.).
Contributors
Chia-Cheng Wen and Kuo-Feng Hsu—contribution to collect the data
Shu-Hui Wen—contribution to statistical analysis
Chang-Chieh Wu—contribution to the design the methods of the study
Shu-Wen Jao—contribution to analyze the result and discussion
Cheng-Wen Hsiao—the leader of this study
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Mai, CM., Wen, CC., Wen, SH. et al. Iatrogenic colonic perforation by colonoscopy: a fatal complication for patients with a high anesthetic risk. Int J Colorectal Dis 25, 449–454 (2010). https://doi.org/10.1007/s00384-009-0822-z
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DOI: https://doi.org/10.1007/s00384-009-0822-z