Colonoscopic perforation treatment results: Experience of 16.385 patients in a single center

INTRODUCTION: Colonoscopy is the most frequently used procedure in the early diagnosis and treatment of many colon diseases, especially colon malignancies. With the increase in the use of colonoscopy, an increase in the number of colonoscopy-related perforations has been observed. This study aimed to determine the frequency of perforation and the management of colonoscopic perforation.
METHODS: Patients who underwent colonoscopy between January 2012 and December 2022 and were determined to have iatrogenic colon perforation were included in the study. The dermographic characteristics of the patients, length of hospital stay, comorbidity status (defined using the guidelines of the American Society of Anesthesiologists), colonoscopy indications, diagnostic tool of perforation, treatment and follow-up methods were examined and collected.
RESULTS: 16,385 patients were examined in the study cohort. Perforation was detected in a total of 12 (0.07%) patients, 8 women and 4 men. The average age of perforated patients was 62 (23-87) years. Eleven patients were treated with surgical intervention and 1 patient was treated with the endoscopic clip method. One patient died on the 20th day after surgery.
DISCUSSION AND CONCLUSION: Although colonoscopic examination is important for the diagnosis and treatment of colon and rectal diseases, the possibility of procedure-related perforation should not be ignored. Early diagnosis enables minimal surgical procedures such as laparoscopic repair and endoscopic clip application. Immediate surgical management, preferably primary repair and sometimes resection, appears to be a good strategy for most patients.