Management of colonoscopic perforations: A systematic review

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Complications

Background:

• Colonoscopy is a vital diagnostic and therapeutic tool.
• Perforation is a rare but serious complication of colonoscopy.
• Significant morbidity and mortality are associated with colonoscopic perforations.

Purpose of the Study:

• To systematically review the literature on the care and outcomes of colonic perforation.
• To develop a management algorithm for colonic perforation.
• To provide guidance for practitioners managing this complication.

Main Methods:

• Systematic literature review adhering to PRISMA-P guidelines.
• Evaluation of 31 articles published within the last 10 years.
• Analysis of data on colonoscopic perforation management and outcomes.

Main Results:

• Colonoscopic perforations are infrequent but exhibit heterogeneous management strategies.
• Therapeutic colonoscopies demonstrate a higher perforation rate than diagnostic ones.
• The sigmoid colon is the most frequent site for perforation.

Conclusions:

• Mortality from colonoscopic perforation is primarily influenced by the patient's pre-existing conditions.
• Treatment strategies should be individualized based on patient comorbidities, clinical status, and perforation circumstances.
• Further research is needed to establish standardized management protocols due to data limitations.