Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Surg Endosc. 2013 Feb;27(2):501-4. doi: 10.1007/s00464-012-2465-3. Epub 2012 Jul 7.
Although the incidence of perforation after endoscopic procedures of the colon is low, the rising number of diagnostic colonoscopies could pose relevant health problems. Optimizing treatment may reduce the probability of severe complications. This study aimed to determine perforation frequency and the management of perforations that occurred during diagnostic colonoscopy.
A retrospective review of patient records was performed for all patients with iatrogenic colonic perforations after sigmoidoscopy/colonoscopy from 2000 to 2011 in three institutions of The Catholic University of Korea. The patients' demographic data, endoscopic procedure information, perforation location, therapy, and outcomes along with different therapeutic strategies were recorded.
In the 12-year period, a total of 115,285 diagnostic sigmoidoscopic/colonoscopic procedures were performed. A total of 27 perforations occurred. Sixteen patients underwent endoscopic clipping, of which three patients failed and were referred for surgery. Fourteen patients in total underwent surgery for perforation. Endoscopic clip closure was successful in 81 % of the patients. No perforation-related major morbidity or mortality occurred.
Endoscopic repair using clips can be effective for the treatment of colon perforations that occur during diagnostic colonoscopy.
虽然内镜结肠检查后穿孔的发生率较低，但诊断性结肠镜检查数量的增加可能会带来相关的健康问题。优化治疗方法可能会降低严重并发症的发生概率。本研究旨在确定诊断性结肠镜检查中发生穿孔的频率和处理方法。
对 2000 年至 2011 年期间，在天主教大学三个机构中，因乙状结肠镜/结肠镜检查而导致的医源性结肠穿孔的所有患者的病历进行回顾性分析。记录患者的人口统计学数据、内镜操作信息、穿孔位置、治疗方法和结果，以及不同的治疗策略。
在 12 年期间，共进行了 115285 例诊断性乙状结肠镜/结肠镜检查。共有 27 例穿孔发生。16 例患者接受了内镜夹闭治疗，其中 3 例失败并转外科治疗。共有 14 例患者接受了手术治疗。内镜夹闭的成功率为 81%。没有与穿孔相关的严重发病率或死亡率。
在诊断性结肠镜检查中，使用夹闭器进行内镜修复可以有效治疗结肠穿孔。
