CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(06): E874-E880
DOI: 10.1055/a-1396-4086
Original article

Paradigm shift in management of acute iatrogenic colonic perforations: 24-year retrospective comprehensive study

Gregorios A. Paspatis
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Maria Fragaki
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Magdalini Velegraki
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Afroditi Mpitouli
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Pinelopi Nikolaou
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Georgios Tribonias
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Evangelos Voudoukis
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Konstantinos Karmiris
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Angeliki Theodoropoulou
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
,
Emmanouil Vardas
Department of Gastroenterology, Benizelion General Hospital, Heraklion-Crete, Greece
› Author Affiliations

Abstract

Background and study aims Through advanced endoscopic clipping techniques, endoscopic treatment of both diagnostic and therapeutic acute iatrogenic colonic perforations has been shown effective. The main purpose of this study was to compare the management of acute iatrogenic perforations (AIPs) of the colon before and after the introduction of advanced clipping techniques.

Methods We conducted a retrospective study from July 1996 to February 2020. The period was divided into two sub periods, Period 1: from July 1996 to December 2012 and Period 2: from January 2013 to March 2020. All AIPs occurring during a colonoscopy and detected during or immediately (< 4 hours) after the procedure, were included in the study.

Results The total number of colonoscopies performed at our hospital was 33055 and 36831 during Periods 1 and 2 respectively. Fifteen perforations were observed in Period 1 and 11 in Period 2. The rate of surgery was 93.3 % % (14/15) in Period 1 and 27.2 % (3 /11) in Period 2 (P < 0.01). The mean hospital stay in Period 1 was 6.9 days and 4 in Period 2 (P < 0.01).

Conclusions Data from this historical cohort have clearly shown a decrease in the surgery rate and the length of hospitalization of AIPs in Period 2 compared to Period 1.

Supplementary material



Publication History

Received: 25 November 2020

Accepted: 11 February 2021

Article published online:
27 May 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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