1Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, and University of Paris Est, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
2Department of Surgery, Maggiore Hospital, Bologna, Italy.
World J Emerg Surg. 2018 Jan 24;13:5. doi: 10.1186/s13017-018-0162-9. eCollection 2018.
Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45-60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator's level of experience, and surgical device availability. Although ICPs have been the focus of numerous publications, no guidelines have been created to standardize the management of ICPs. The aim of this article is to present the World Society of Emergency Surgery (WSES) guidelines for the management of ICP, which are intended to be used as a tool to promote global standards of care in case of ICP. These guidelines are not meant to substitute providers' clinical judgment for individual patients, and they may need to be modified based on the medical team's level of experience and the availability of local resources.
医源性结肠镜穿孔（ICP）是一种严重的并发症，可在诊断和治疗过程中发生。尽管 45-60%的 ICP 在进行结肠镜检查时由内镜医生诊断，但许多 ICP 并未立即被识别，而是基于内镜手术后出现的临床体征和症状被怀疑。ICP 的主要治疗方法有三种：内镜修复、保守治疗和手术。治疗方法必须根据诊断的设置（内镜检查期间或之后）、ICP 的类型、患者的特征和一般状况、操作人员的经验水平以及手术设备的可用性而有所不同。尽管 ICP 已经成为众多出版物的焦点，但尚未制定指南来规范 ICP 的管理。本文的目的是介绍世界急诊外科学会（WSES）的 ICP 管理指南，旨在为 ICP 病例提供一个促进全球护理标准的工具。这些指南并非旨在替代提供者对个别患者的临床判断，并且可能需要根据医疗团队的经验水平和当地资源的可用性进行修改。
