A Comparative Analysis of Treatment Methods for Colonic Perforation During Colonoscopy

Abstract

Background/Aims: Successful managmemnt of colonoscopic perforation by nonoperative treatment has been reported but its management remains controversial. We compared operative and nonoperative managements and aimed to assess the prognostic factors and mortality due to colonoscopic perforations. Methods: A large-scale, multicenter, retrospective analysis was conducted in the five tertiary hospitals in Daegu, Korea. Results: Thirty-nine cases of colon perforations occurred out of 70,659 colonoscopic procedures in the five institutions and the overall incidence was 0.06%. Additional five cases were referred from primary practitioners. They were managed with (n=18) or without (n=16) surgical intervention. There were no statistically significant differences in age, sex, hospital stay and mortality rate between the two groups. Overall three cases of death occurred; one case (5.6%) in the operative group and two (7.7%) in the nonoperative group, but no statistically significant difference in mortality rate was observed (p=1.000). The status of completeness of bowel preparation was important factor for preventing patient mortality (p=0.001). Conclusion: Colonic perforation during the colonoscopy can be successfully treated with either operative or nonoperative management in patients with adequate bowel preparation.