Laparoscopic approach of colonic perforation due to colonoscopy

Background: Iatrogenic perforation due to colonoscopy is the most serious complication of this procedure. Usually this complication requires segmental resection to be resolved. The laparoscopic approach could be an option to minimize the outcome of this complication.
Objective: The aim of this study was to assess the effectiveness of the laparoscopic approach to treat colonic perforations due to colonoscopy.
Methods: Data were collected retrospectively on all patients who underwent conoloscopy and had perforation between July 1997 and July 2007.
Patients with other complications after colonoscopy as well as other colonic perforations were excluded. Patients were divided in two groups; G1 (Group 1): laparoscopic colectomy and G2 (Group 2): open colectomy. Morbidity rate and recovery parameters were evaluated between the groups.
Statistical analysis was performed using student t test and chi square test.
Results: 10233 colonoscopies were performed. 7572 (74%) were diagnostics and 2661 (26%) therapeutics. There were 16 (0.15%) iatrogenic perforations (G1=10 vs. G2=6). The mean age of the patients was 62 ± 12.1 years. There were no differences in patients demography, co-morbidities, and ASA grades between the groups. 9 patients from G1 had segmental colectomy. One patient had a diverting ileostomy associated. Patients from G1 had lower hospital stay and lower complications comparing with G2. [(G1 4.5 ± 2.06 days vs. G2 11.5 ± 8.8 days, p = 0.02) (G1: 1 vs. G2: 5, p = 0.043)]
Conclusions: laparoscopic colectomy is an effective procedure to resolve colonic perforation due to colonoscopy and might offers benefits when is compared with open approach.


Session: Podium Presentation

Program Number: S099

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