Laparoscopic Surgery for Iatrogenic Colonic Perforations

Abstract

Colonoscopy has a small, but serious risk of colonic perforation. Iatrogenic perforation of the colon is the most feared complication of colonoscopy. Basically, iatrogenic colonic perforations have been treated with an emergency operation. In order to avoid further patient trauma and surgical stresses, laparoscopic treatment is feasible. At our hospital, emergency laparoscopic surgery is performed on patients with iatrogenic colon perforation as long as that they can be placed under general anesthesia with sufficient informed consent. We prudently indicate this procedure for iatrogenic colonic perforations. From January 1995 through March 2013, there were 14 patients who underwent laparoscopic surgery for iatrogenic colonic perforation at our institution. The surgery time was shorter and the amount of bleeding was smaller than a control group. There were no significant differences in the postoperative stay between the iatrogenic perforation group and the control group. Further, there was no significant difference in the incidence of postoperative complications between the two groups. The results of the present study showed no statistically significant differences in the clinical course soon after surgery between the iatrogenic perforation and control groups, thus suggesting that emergency laparoscopic surgery can be performed on iatrogenic perforated cases with sufficient preoperative assessment and well skilled operation by experienced laparoscopic surgeons.