A Comparative Analysis of Treatment Methods for
Colonic Perforation During Colonoscopy

Keimyung Medical Journal 2010;29(1):13-20.

A Comparative Analysis of Treatment Methods for Colonic Perforation During Colonoscopy

Seung Hyun Lee; Hyun Ah Kim; Woo Jin Chung; Kyung Sik Park; Kwang Bum Cho; Jae Seok Hwang; Seong Woo Jeon; Chang Min Cho; Jin Tae Jung; Ho Gak Kim; Byung Ik Jang; Tae Nyun Kim; Chang Keun Park; Hyeon Su Kim

Abstract

Background/Aims
Successful managmemnt of colonoscopic perforation by nonoperative treatment has been reported but its management remains controversial. We compared operative and nonoperative managements and aimed to assess the prognostic factors and mortality due to colonoscopic perforations.
Methods
A large-scale; multicenter; retrospective analysis was conducted in the five tertiary hospitals in Daegu; Korea.
Results
Thirty-nine cases of colon perforations occurred out of 70;659 colonoscopic procedures in the five institutions and the overall incidence was 0.06%. Additional five cases were referred from primary practitioners. They were managed with (n=18) or without (n=16) surgical intervention. There were no statistically significant differences in age; sex; hospital stay and mortality rate between the two groups. Overall three cases of death occurred; one case (5.6%) in the operative group and two (7.7%) in the nonoperative group; but no statistically significant difference in mortality rate was observed (p=1.000). The status of completeness of bowel preparation was important factor for preventing patient mortality (p=0.001). Conclusion: Colonic perforation during the colonoscopy can be successfully treated with either operative or nonoperative management in patients with adequate bowel preparation.

Key Words: Colonoscopic perforation