The analysis of outcomes of surgical management for colonoscopic perforations: A 16-years experiences at a single institution

Abstract

Colonoscopy-induced colonic perforation often requires surgical management. The aim of this study was to analyze the outcomes after surgery for colonoscopic perforations (CPs). This was a retrospective chart review study of 48 patients who underwent surgery for CPs between January 2002 and May 2017. The patients were divided into two groups: Group I (n=25) had diagnostic CPs, and Group II (n=23) had therapeutic CPs. The most common perforation sites in Group I were the sigmoid colon (n=19; 76.0%), whereas in Group II were the transverse colon (n=10, 43.5%) and sigmoid colon (n=10, 43.5%; p=0.013). The surgeries performed were primary closure (n=16, [64.0%] Group I; n=11 [47.8%] Group II) and bowel resection (n=9 [36.0%] Group I; n=11 [47.8%] Group II). The rate of temporary stomas was higher in Group II (n=9, 26.1%) than Group I (n=2, 8.0%; p=0.030). The re-perforation rate after surgery was 8.0% (n=2) in Group I and 8.7% (n=2) in Group II (p=0.568). These re-perforation patients all those who had a simple closure without a wedge resection. The conversion rate after laparoscopic surgery was 20.0% (n=2 of 10) in Group I and 33.3% (n=1 of 3) in Group II. Surgical management is one of the important therapies in the treatment of CP. Simple primary closure without a wedge resection should be used cautiously. Therapeutic CPs was associated with more temporary stoma formation. The type of surgery should be carefully selected, depending on the type of CP.