Surgical treatment of colonoscopy-related complications
Journal Title: Gastroenterologia Polska - Year 2006, Vol 13, Issue 3
Abstract
Introduction: Severe colonoscopy-related complications such as bowel perforation or hemorrhage usually require surgical treatment. Objectives: Aim of the paperwas a retrospective analysis and evaluation of therapeutic outcomes of patients in whom surgical treatment of colonoscopy-related complications was performed. Material and methods: The study included 2105 patients who underwent either diagnostic or therapeutic colonoscopy from 2003 to 2005. Type of complications after the procedure, time interval between complications and diagnosis,techniques of surgical treatment, postoperative complications and duration of hospital stay were recorded and analyzed aswell. Results: 10 out of 2105 patients were operated because of colonoscopy-related complications. In 8 out of 10 subjects colon perforation and in 2 - massive hemorrhage were diagnosed. Perforation occurred after 6 diagnostic and 2 therapeutic colonoscopies. Although most perforations were already diagnosed during the colonoscopy, in two cases microperforations were detected later (after 6 h and 2 days after the procedure). In most cases perforation occurred in sigmoid colon. All the patients with bowel perforation underwent surgical treatment. In 4 cases simple suturing of a perforation place was done, the restof the patients underwent either partial colectomy with end-to-end anastomosis, colectomy with terminal ileostomy or loop-ileostomy and peritoneal cavity drainage. Postoperative complications developed in three patients, one patient died. Post-polypectomy hemorrhages were controlled by sutureligation of bleeding vessels with no postoperative complications. Conclusions: Surgical therapy is mandatory in all cases of post-endoscopic bowel perforation. The choice of surgical technique depends on the extent and duration of perforation, degree of peritoneal contamination, general condition of the patient and co-existing diseases.
Authors and Affiliations
Andrzej Sygut, Przemysław Galbfach, Piotr Narbutt, Anna Kędzierska, Małgorzata Lewandowska, Adam Dzik
Keywords
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