Abstract
Purpose. We present our experience with laparoscopic colorrhaphy as definitive surgical modality for the management of colonoscopic perforations. Methods. Over a 17-month period, we assessed the outcomes of consecutive patients presenting with acute colonoscopic perforations. Patient characteristics and perioperative parameters were tabulated. Postoperative outcomes were evaluated within 30 days following discharge. Results. Five female patients with a mean age of 71.4 ± 9.7 years (range: 58–83), mean BMI of 26.4 ± 3.4 kg/m2 (range: 21.3–30.9), and median ASA score of 2 (range: 2-3) presented with acute colonoscopic perforations. All perforations were successfully managed through laparoscopic colorrhaphy within 24 hours of development. The perforations were secondary to direct trauma (n = 3) or thermal injury (n = 2) and were localized to the sigmoid (n = 4) or cecum (n = 1). None of the patients required surgical resection, diversion, or conversion to an open procedure. No intra- or postoperative complications were encountered. The mean length of hospital stay was 3.8 ± 0.8 days (range: 3–5). There were no readmissions or reoperations. Conclusion. Acute colonoscopic perforations can be safely managed via laparoscopic primary repair without requiring resection or diversion. Early recognition and intervention are essential for successful outcomes.
Highlights
Iatrogenic perforation represents an uncommon yet potentially life-threatening complication during colonoscopy [1, 2]
We present our experience with laparoscopic colorrhaphy as de nitive surgical modality for the management of colonoscopic perforations
Five female patients presented with acute iatrogenic colonic perforation, which occurred during screening colonoscopy. e mean age, mean body mass index (BMI), and median American Society of Anesthesiologists (ASA) of the patients were 71.4 ± 9.7 years, 26.4 ± 3.4 kg/m2, and 2, respectively (Table 1). ree perforations were secondary to mechanical trauma and recognized during the colonoscopy, while two perforations occurred due to thermal injury and were identi ed within 24 hours of the colonoscopy. e perforations were located in the sigmoid and cecum
Summary
Iatrogenic perforation represents an uncommon yet potentially life-threatening complication during colonoscopy [1, 2]. Patients have required open surgery with either primary repair of the perforation or bowel resection with or without ostomy creation [1, 3, 4]. These procedures are an effective approach, they o en require large open incisions and may be associated with high complication rates, such as wound infection and hernias [1, 4]. Invasive colorectal surgery represents an efficacious alternative to the open approach, utilizing smaller incisions and resulting in diminished postoperative pain, earlier recovery, and lower postoperative morbidity [5,6,7,8,9]. Our aim was to assess and report our initial experience with laparoscopic primary repair of acute colonic perforations during colonoscopy
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