Saraste Deborah, Martling Anna, Nilsson Per J, Blom Johannes, Törnberg Sven, Hultcrantz Rolf, Janson Martin
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
J Med Screen. 2016 Sep;23(3):135-40. doi: 10.1177/0969141315625701. Epub 2016 Mar 2.
To report complications after colonoscopy and surgery in patients with neoplasia detected through a population based colorectal cancer (CRC) screening programme in the capital region of Sweden.
Patients who after a positive FOBT screening result underwent colonoscopy from 1 January 2008 to 30 June 2012 were included. Mortality and complications within 30 days after colonoscopy or subsequent surgery were identified through national registers, and complications were assessed through review of medical charts. Complications were graded using the Clavien-Dindo classification.
After 2984 colonoscopies, the complication rate was 1%. The risk of post-polypectomy bleeding was 14/1000. The risk of perforation was 1/1000 after a diagnostic colonoscopy and 2.5/1000 after a colonoscopy with polypectomy. One patient developed a post-polypectomy syndrome. There was one death which was not related to the colonoscopy. After surgery for 37 adenomas and 155 CRCs, the total complication rates were 27% and 50%, respectively. The rate of anastomotic leakage was 13% and 12% after surgery for adenomas and CRC, respectively. There were no deaths after surgery. The overall complication rate after colonoscopy and surgery for adenomas and cancer was 4%.
Overall complication rates were acceptable and mortality low; however, the rate of anastomotic leakage after surgery for both adenomas and CRC was higher than expected.
报告在瑞典首都地区通过基于人群的结直肠癌（CRC）筛查计划检测到肿瘤的患者进行结肠镜检查和手术后的并发症情况。
纳入2008年1月1日至2012年6月30日期间粪便潜血试验（FOBT）筛查结果呈阳性后接受结肠镜检查的患者。通过国家登记系统确定结肠镜检查或后续手术后30天内的死亡率和并发症情况，并通过查阅病历评估并发症。使用Clavien-Dindo分类法对并发症进行分级。
2984例结肠镜检查后，并发症发生率为1%。息肉切除术后出血风险为14/1000。诊断性结肠镜检查后穿孔风险为1/1000，息肉切除术后结肠镜检查后穿孔风险为2.5/1000。1例患者出现息肉切除术后综合征。有1例死亡与结肠镜检查无关。37例腺瘤和155例结直肠癌手术后，总并发症发生率分别为27%和50%。腺瘤和结直肠癌手术后吻合口漏发生率分别为13%和12%。手术后无死亡病例。腺瘤和癌症结肠镜检查及手术后的总体并发症发生率为4%。
总体并发症发生率可接受且死亡率低；然而，腺瘤和结直肠癌手术后吻合口漏发生率高于预期。
