Laparoscopic Repair of Colonoscopic Perforations: Indications and Guidelines

Hansen, Adam J.; Tessier, Deron J.; Anderson, Marlys; Schlinkert, Richard T.

doi:10.1007/s11605-007-0137-8

Cited by 77 publications

(79 citation statements)

References 16 publications

(16 reference statements)

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“…The role of laparoscopy in colonic perforation caused by colonoscopy has been reported mainly as case reports or case series involving less than 20 patients [39][40][41][42]. These studies have confirmed the excellent results of laparoscopic surgery regarding reduced morbidity, mortality and hospital stay ( Table 1).…”

Section: Colorectal Emergenciesmentioning

confidence: 81%

“…These studies have confirmed the excellent results of laparoscopic surgery regarding reduced morbidity, mortality and hospital stay ( Table 1). The patients in whom there is doubt about integrity of laparoscopic repair or the perforation is not localized should be converted to an open procedures [39] In the western world, acute diverticulitis is a common colonic emergency. Complications of acute diverticulitis are classified according to modified Hinchey classification (Table 2).…”

Section: Colorectal Emergenciesmentioning

confidence: 99%

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Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

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Laparoscopy has already established itself as the preferred surgical approach in a variety of elective surgical conditions. Along with its usual advantages of less tissue trauma and faster recovery, its diagnostic as well as therapeutic role is making it an attractive option in emergency surgery. In this paper, we have reviewed the current status of laparoscopic surgery in luminal gastrointestinal emergencies. Relevant papers were selected using Medline database from 2007 to the present. These were reviewed, and outcomes were stated under the headings of appendicitis, perforated peptic ulcer, colorectal emergencies and small bowel obstruction. The laparoscopic intervention was found to be of clear benefit in most of the patients with appendicitis. Its role, however, is not absolutely clear in managing perforated peptic ulcers. Laparoscopic lavage and drainage have been recommended in diverticular perforation with limited contamination. Small case series and studies have shown benefits of laparoscopic surgery in iatrogenic colonic perforations, colonic obstruction, emergency colectomy and small bowel obstruction. Laparoscopic surgery can be recommended in appendicitis and lowrisk cases of perforated peptic ulcers. Its definitive role in other conditions needs more evidence. The surgeon's experience and careful patient selection are very important to improve the outcome.

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Section: Colorectal Emergenciesmentioning

confidence: 81%

Section: Colorectal Emergenciesmentioning

confidence: 99%

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

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“…Stoma can be considered in cases of intensive contamination. The number of laparoscopic colonic repairs for colorectal perforations has increased recently with developments in minimally invasive surgical procedures (11,14). Zhang et al (15) reported in their study that laparoscopic repair is a safe and feasible repair method.…”

Section: Discussionmentioning

confidence: 99%

Emergency cases following elective colonoscopy: Iatrogenic colonic perforation

et al. 2017

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Emergency cases following elective colonoscopy: Iatrogenic colonic perforation INTRODUCTIONColonoscopy is commonly used in the diagnosis, treatment, and follow-up of colorectal diseases. It is generally acknowledged to be a safe procedure. The most frequent colonoscopy-related complication is post-polypectomy bleeding. The number of patients necessitating surgical intervention related to bleeding is very low (1). Colonoscopy-related colonic perforation is seen less than bleeding; however, it is still a significant complication that can lead to morbidity and mortality (2). The prevalence of post-colonoscopic perforation is 0.03% to 0.8% in diagnostic colonoscopy procedures, while it varies between 0.3% and 3% in therapeutic colonoscopies (3). There is still no consensus on the optimal treatment of iatrogenic colonic perforations because there are no prospective randomized and controlled studies in the literature. In this study, we present the cases of our patients who contracted colonic perforation during elective colonoscopy and who were transformed into emergency cases, along with their treatment modalities. MATERIAL AND METHOD The PatientsThe cases of patients who contracted iatrogenic colonic perforation following endoscopy of the colorectal system between January 2009 and December 2015 at Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital's Endoscopy Unit were reviewed retrospectively. The study was made according to Helsinki Declaration.The total numbers of diagnostic and interventional colonoscopy and sigmoidoscopy procedures along with the total number of polypectomy and biopsy procedures conducted within the scope of interventional colonoscopy were determined within the designated timeframe of the study.Endoscopic investigations are performed by gastroenterology surgery specialists and sub-specialty residents with gastroenterology specialists at the endoscopy unit of our hospital. All the patients signed detailed informed consent forms before the procedure. Patients who recently experienced myocardial Objective: Our aim in this study was to present the cases of our patients who contracted colonic perforation during elective colonoscopy and became emergency cases; we also discuss treatment modalities along with literature reports on the subject. Material and Methods:Cases of patients who contracted iatrogenic colonic perforation following endoscopy of the colorectal system between January 2009 and December 2015 at Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital's Endoscopy Unit were reviewed retrospectively. Results:Within the duration of the study, 5.586 patients underwent colonoscopies at our hospital; 7 (0.12%) of these patients contracted iatrogenic colonic perforation. Three (42.8%) of these patients were male, four (57.2%) were female, and their mean age was 69 years (46 to 84). Six (85.7%) patients were diagnosed intraoperationally, while one (14.3%) patient was diagnosed 12 hours after the procedure. The perforation area was the sigmoid colon in six patients and the ascend...

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“…5 The diagnostic yield of the laparoscope is also invaluable at very little risk to the patient, always leaving the option of conversion to laparotomy, 1,2 especially in cases of extensive peritoneal irritation, massive fecal soilage, or complex colonic injury. 6 …”

Section: Discussionmentioning

confidence: 99%