The Outcomes of Management for Colonoscopic Perforation: A 12-Year Experience at a Single Institute. | - CCMAR -

Journal Article

TitleThe Outcomes of Management for Colonoscopic Perforation: A 12-Year Experience at a Single Institute.
Publication TypeJournal Article
AuthorsPark, JYun, Choi, PWha, Jung, SMin, Kim, N-H
Year of Publication2016
JournalAnn Coloproctol
Volume32
Issue5
Date Published2016 Oct
Pagination175-183
ISSN2287-9714
Abstract

PURPOSE: Optimal management of colonoscopic perforation (CP) is controversial because early diagnosis and prompt management play critical roles in morbidity and mortality. Herein, we evaluate the outcomes and clinical characteristics of patients with CP according to treatment modality to help establish guidelines for managing CP.METHODS: Our retrospective analysis included 40 CP patients from January 1, 2003, to December 31, 2014. Patients with CP were categorized into 2 groups according to therapeutic modality: operation (surgery) and nonoperation (endo-luminal clip application or conservative treatment) groups.RESULTS: The postoperative morbidity rate was 40%, and no mortalities were noted. The incidence of abdominal pain and tenderness in patients who received only conservative management was significantly lower than in those who underwent surgery (P < 0.001 and P = 0.004, respectively). Patients tended to undergo surgery more often for diagnosis times longer than 24 hours and for diagnostic CPs. The mean hospital stays for the operation and nonoperation groups were 14.6 ± 7.77 and 5.9 ± 1.62 days, respectively (P < 0.001). Compared to the operation group, the nonoperation group began intake of liquid diets significantly earlier after perforation (3.8 ± 1.32 days vs. 5.6 ± 1.25 days, P < 0.001) and used antibiotics for a shorter duration (4.7 ± 1.29 days vs. 8.7 ± 2.23 days, P < 0.001).CONCLUSION: The time of diagnosis and the injury mechanism may be useful indications for conservative management. Nonoperative management, such as endo-luminal clip application, might be beneficial, when feasible, for the treatment of patients with CP.

DOI10.3393/ac.2016.32.5.175
Sapientia

http://www.ncbi.nlm.nih.gov/pubmed/27847788?dopt=Abstract

Alternate JournalAnn Coloproctol
PubMed ID27847788
PubMed Central IDPMC5108664
CCMAR Authors