Laparoscopic primary colorrhaphy for acute iatrogenic perforations during colonoscopy

Abstract

Purpose. We present our experience with laparoscopic colorrhaphy as de-nitive surgical modality for the management of colonoscopic perforations. Methods. Over a 17-month period, we assessed the outcomes of consecutive patients presenting with acute colonoscopic perforations. Patient characteristics and perioperative parameters were tabulated. Postoperative outcomes were evaluated within 30 days following discharge. Results. Five female patients with a mean age of 71.4 ± 9.7 years (range: 58-83), mean BMI of 26.4 ± 3.4 kg/m2 (range: 21.3-30.9), and median ASA score of 2 (range: 2-3) presented with acute colonoscopic perforations. All perforations were successfully managed through laparoscopic colorrhaphy within 24 hours of development. -eperforations were secondary to direct trauma (- = 3) or thermal injury (- = 2) and were localized to the sigmoid (- = 4) or cecum (- = 1). None of the patients required surgical resection, diversion,w or conversion to an open procedure. No intra- or postoperative complications were encountered. -e mean length of hospital stay was 3.8 ± 0.8 days (range: 3-5). -ere were no readmissions or reoperations. Conclusion. Acute colonoscopic perforations can be safely managed via laparoscopic primary repair without requiring resection or diversion. Early recognition and intervention are essential for successful outcomes. Copyright © 2013 Eric M. Haas et al.