Factors Associated with the Clinical Outcomes of Iatrogenic Colonic Perforation
Background/Aims: This study evaluated the incidence of iatrogenic colonic perforation (ICP) in a high-volume center and analyzed the clinical outcomes and associated factors. Methods: As a retrospective study of the electronic medical records, the whole data of patients who underwent colonoscopy fr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Jin Publishing & Printing Co.
2022-05-01
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| Series: | The Korean Journal of Gastroenterology |
| Subjects: | |
| Online Access: | https://www.kjg.or.kr/journal/view.html?uid=5819&vmd=Full |
| _version_ | 1827805999031910400 |
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| author | Hyun Jin Lee Han Hee Lee Dae Young Cheung Jin Il Kim Soo-Heon Park |
| author_facet | Hyun Jin Lee Han Hee Lee Dae Young Cheung Jin Il Kim Soo-Heon Park |
| author_sort | Hyun Jin Lee |
| collection | DOAJ |
| description | Background/Aims: This study evaluated the incidence of iatrogenic colonic perforation (ICP) in a high-volume center and analyzed the clinical outcomes and associated factors.
Methods: As a retrospective study of the electronic medical records, the whole data of patients who underwent colonoscopy from June 2004 to May 2020 were reviewed.
Results: During 16 years, 69,458 procedures were performed, of which 60,288 were diagnostic and 9,170 were therapeutic. ICP occurred in 0.027% (16/60,288) for diagnostic colonoscopies and in 0.076% (7/9,170) for therapeutic purposes (p=0.015; hazard ratio 2.878; 95% CI, 1.184-6.997). Fifty-two percent (12 cases) were managed with endoscopic clip closure, and 43.5% (10 cases)
required surgery. The reasons for the procedure and the procedure timing appeared to affect the treatment decision. Perforations during therapeutic colonoscopy were treated with surgery more often than those for diagnostic purposes (66.7% [4/6] vs. 37.5% [6/16], p=0.221). Regarding the timing of the procedure, ICP that occurred in the afternoon session was more likely treated surgically (56.3% [9/16] vs. 0/5, p=0.027). Mortality occurred in two patients (2/23, 8.7%). Both were aged (mean age 84.0±1.4 vs. 65.7±10.5, p<0.001) and lately recognized (mean elapsed time [hours], 43.8±52.5 vs. 1.5±3.0, p<0.001) than the surviving patients.
Conclusions: ICP occurs in less than 0.1% of cases. The events that occurred during the morning session were more likely managed endoscopically. Age over 80 years and a longer time before perforation recognition were associated with mortality. |
| first_indexed | 2024-03-11T21:34:11Z |
| format | Article |
| id | doaj.art-c29249b9af7d476b83f55ce0a81c7b4e |
| institution | Directory Open Access Journal |
| issn | 1598-9992 2233-6869 |
| language | English |
| last_indexed | 2024-03-11T21:34:11Z |
| publishDate | 2022-05-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj.art-c29249b9af7d476b83f55ce0a81c7b4e2023-09-27T05:07:52ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922233-68692022-05-0179521021610.4166/kjg.2022.024Factors Associated with the Clinical Outcomes of Iatrogenic Colonic PerforationHyun Jin Lee0Han Hee Lee1Dae Young Cheung2https://orcid.org/0000-0003-4150-3555Jin Il Kim 3Soo-Heon Park4Department of Internal Medicine, Myongji Hospital, Goyang, KoreaDepartment of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, KoreaDepartment of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, KoreaBackground/Aims: This study evaluated the incidence of iatrogenic colonic perforation (ICP) in a high-volume center and analyzed the clinical outcomes and associated factors. Methods: As a retrospective study of the electronic medical records, the whole data of patients who underwent colonoscopy from June 2004 to May 2020 were reviewed. Results: During 16 years, 69,458 procedures were performed, of which 60,288 were diagnostic and 9,170 were therapeutic. ICP occurred in 0.027% (16/60,288) for diagnostic colonoscopies and in 0.076% (7/9,170) for therapeutic purposes (p=0.015; hazard ratio 2.878; 95% CI, 1.184-6.997). Fifty-two percent (12 cases) were managed with endoscopic clip closure, and 43.5% (10 cases) required surgery. The reasons for the procedure and the procedure timing appeared to affect the treatment decision. Perforations during therapeutic colonoscopy were treated with surgery more often than those for diagnostic purposes (66.7% [4/6] vs. 37.5% [6/16], p=0.221). Regarding the timing of the procedure, ICP that occurred in the afternoon session was more likely treated surgically (56.3% [9/16] vs. 0/5, p=0.027). Mortality occurred in two patients (2/23, 8.7%). Both were aged (mean age 84.0±1.4 vs. 65.7±10.5, p<0.001) and lately recognized (mean elapsed time [hours], 43.8±52.5 vs. 1.5±3.0, p<0.001) than the surviving patients. Conclusions: ICP occurs in less than 0.1% of cases. The events that occurred during the morning session were more likely managed endoscopically. Age over 80 years and a longer time before perforation recognition were associated with mortality.https://www.kjg.or.kr/journal/view.html?uid=5819&vmd=Fullcolonoscopycolonperforationmortality |
| spellingShingle | Hyun Jin Lee Han Hee Lee Dae Young Cheung Jin Il Kim Soo-Heon Park Factors Associated with the Clinical Outcomes of Iatrogenic Colonic Perforation The Korean Journal of Gastroenterology colonoscopy colon perforation mortality |
| title | Factors Associated with the Clinical Outcomes of Iatrogenic Colonic Perforation |
| title_full | Factors Associated with the Clinical Outcomes of Iatrogenic Colonic Perforation |
| title_fullStr | Factors Associated with the Clinical Outcomes of Iatrogenic Colonic Perforation |
| title_full_unstemmed | Factors Associated with the Clinical Outcomes of Iatrogenic Colonic Perforation |
| title_short | Factors Associated with the Clinical Outcomes of Iatrogenic Colonic Perforation |
| title_sort | factors associated with the clinical outcomes of iatrogenic colonic perforation |
| topic | colonoscopy colon perforation mortality |
| url | https://www.kjg.or.kr/journal/view.html?uid=5819&vmd=Full |
| work_keys_str_mv | AT hyunjinlee factorsassociatedwiththeclinicaloutcomesofiatrogeniccolonicperforation AT hanheelee factorsassociatedwiththeclinicaloutcomesofiatrogeniccolonicperforation AT daeyoungcheung factorsassociatedwiththeclinicaloutcomesofiatrogeniccolonicperforation AT jinilkim factorsassociatedwiththeclinicaloutcomesofiatrogeniccolonicperforation AT sooheonpark factorsassociatedwiththeclinicaloutcomesofiatrogeniccolonicperforation |