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colonoscopic perforation:Incidence,risk factors,management and outcome

World Journal of Gastroenterology 2010年第4期16卷 425-430页

作者： Varut Lohsiriwat Department of Surgery Faculty of MedicineSiriraj HospitalMahidol UniversityBangkok 10700Thailand

This review discusses the incidence,risk factors,management and outcome of colonoscopic perforation(CP).The incidence of CP ranges from 0.016% to 0.2% following diagnostic colonoscopies and could be up to 5% following some colonoscopic *** perforations are frequently related to therapeutic colonoscopies and are associated with patients of advanced age or with multiple *** of CP is mainly based on patients' clinical grounds and their underlying colorectal *** therapeutic approaches include conservative management(bowel rest plus the administration of broadspectrum antibiotics),endoscopic management,and operative management(open or laparoscopic approach).The applications of each treatment are *** outcomes of patients with CP are also addressed.

关键词： colonoscopic perforation Colonoscopy Sigmoidoscopy Complication Postpolypectomy syndrome Incidence Risk factors Treatment Management Outcome

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colonoscopic perforation:A report from World Gastroenterology Organization endoscopy training center in Thailand

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World Journal of Gastroenterology 2008年第43期14卷 6722-6725页

作者： Varut Lohsiriwat Sasithorn Sujarittanakarn Thawatchai Akaraviputh Narong Lertakyamanee Darin Lohsiriwat Udom Kachinthorn Siriraj GI Endoscopy center Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Siriraj GI Endoscopy center Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand

AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training Center in Thailand. METHODS： All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients＇ characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS： A total of 17357 endoscopic procedures of the colon （13 699 colonoscopies and 3658 flexible sigmoidoscopies） were performed in Siriraj hospital over a 9-year period. Fifteen patients （0.09%） had CP： 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon （80%）, followed by the transverse colon （13%）. perforations were caused by direct trauma from either the shaft or the tip of the endoscope （n = 12,80%） and endoscopic polypectomy （n = 3, 20%）. All patients with CP underwent surgical management： primary repair （27%） and bowel resection （73%）. The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION： CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.

关键词： colonoscopic perforation Colonoscopy Complication Incidence Endoscopy training center

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