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结肠镜检查、诊断/治疗及随访过程中的医源性结肠穿孔:单中心经验

Iatrogenic colon perforation during colonoscopy, diagnosis/treatment, and follow-up processes: A single-center experience.

作者信息

Gülaydın Nihat, İliaz Raim, Özkan Atakan, Gökçe A Hande, Önalan Hanifi, Önalan Berrin, Arı Aziz

机构信息

Department of General Surgery, Atlas University Faculty of Medicine, İstanbul, Türkiye.

Department of Gastroenterology, Atlas University Faculty of Medicine, İstanbul, Türkiye.

出版信息

Turk J Surg. 2022 Sep 19;38(3):221-229. doi: 10.47717/turkjsurg.2022.5638. eCollection 2022 Sep.

Abstract

OBJECTIVES

latrogenic colon perforation (ICP) is one of the most feared complications of colonoscopy and causes unwanted morbidity and mortality. In this study, we aimed to discuss the characteristics of the cases of ICP we encountered in our endoscopy clinic, its etiology, our treatment approaches, and results in the light of the current literature.

MATERIAL AND METHODS

We retrospectively evaluated the cases of ICP among 9.709 lower gastrointestinal system endoscopy procedures (colonoscopy + rectosigmoidoscopy) performed for diagnostic purposes in our endoscopy clinic during 2002-2020.

RESULTS

A total of seven cases of ICP were detected. The diagnosis was made during the procedure in six patients and after eight hours in one patient, and their treatment was performed urgently. Whereas surgical procedures were performed in all patients, the type of the procedure varied; laparoscopic primary repair was performed in two patients and laparotomy in five patients. In the patients who underwent laparotomy, primary repair was performed in three patients, partial colon resection and end-to-end anastomosis in one patient, and loop colostomy in one patient. The patients were hospitalized for an average of 7.14 days. The patients who did not develop complications in the postoperative follow-up were discharged with full recovery.

CONCLUSION

Prompt diagnosis and appropriate treatment of ICP is crucial to prevent morbidity and mortality.

摘要

目的

医源性结肠穿孔(ICP)是结肠镜检查最可怕的并发症之一,会导致不良的发病率和死亡率。在本研究中,我们旨在根据当前文献,探讨我们在内镜门诊遇到的ICP病例的特征、病因、治疗方法及结果。

材料与方法

我们回顾性评估了2002年至2020年期间在我们内镜门诊进行的9709例用于诊断目的的下消化道系统内镜检查(结肠镜检查+直肠乙状结肠镜检查)中的ICP病例。

结果

共检测到7例ICP。6例患者在检查过程中确诊,1例患者在8小时后确诊,并对他们进行了紧急治疗。虽然所有患者均接受了手术治疗,但手术方式各不相同;2例患者进行了腹腔镜一期修复,5例患者进行了剖腹手术。在接受剖腹手术的患者中,3例患者进行了一期修复,1例患者进行了部分结肠切除和端端吻合,1例患者进行了袢式结肠造口术。患者平均住院7.14天。术后随访未出现并发症的患者完全康复出院。

结论

及时诊断和适当治疗ICP对于预防发病率和死亡率至关重要。

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