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Iatrogenic colonic perforation: repair using laparoscopic technique.

Lucia Miranda1, Anna Settembre, Domenico Piccolboni

  • 1Department of General Surgery, Monaldi Hospital via L. Bianchi, Napoli, Italy. lumira@email.it

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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Summary

Laparoscopic surgery offers a safe and effective treatment for iatrogenic colonic perforations, a rare colonoscopy complication. This minimally invasive approach presents a viable alternative to traditional open surgery or nonoperative management.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Complications

Background:

  • Iatrogenic colonic perforation is a rare but serious complication following colonoscopy.
  • Current management strategies lack specific guidelines, ranging from nonoperative approaches to open surgery.
  • Optimal treatment for these perforations remains a subject of debate.

Purpose of the Study:

  • To evaluate the safety and efficacy of laparoscopic techniques for managing iatrogenic colonic perforations.
  • To compare laparoscopic outcomes with existing treatment options.

Main Methods:

  • Retrospective analysis of 9 patients with iatrogenic colonic perforations treated between February 2002 and August 2009.
  • Laparoscopic procedures included colorrhaphy, resection with anastomosis, and the Hartmann procedure.

Main Results:

  • All 9 patients successfully underwent laparoscopic treatment.
  • No mortality was observed in the study cohort.
  • Laparoscopic approaches demonstrated successful outcomes for various perforation severities.

Conclusions:

  • Laparoscopic treatment for iatrogenic colonic perforations is a safe and effective option.
  • It offers a balance between the risks of nonoperative management and the invasiveness of open surgery.
  • Laparoscopic approach may be considered a first-choice treatment modality, warranting further investigation.