TY  - BOOK
AU  - Hajiyeva, Gulara
TI  - Endoscopic management of colonic perforations: clips versus suturing closure (with videos)
SN  - 0016-5107
PY  - 2016///
KW  - *Colonic Diseases/su [Surgery]
KW  - *Colonoscopy/mt [Methods]
KW  - *Intestinal Perforation/su [Surgery]
KW  - *Surgical Instruments
KW  - *Suture Techniques
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Colon/in [Injuries]
KW  - Colon/su [Surgery]
KW  - Colonic Diseases/et [Etiology]
KW  - Colonoscopy/ae [Adverse Effects]
KW  - Female
KW  - Humans
KW  - Intestinal Perforation/et [Etiology]
KW  - Male
KW  - Middle Aged
KW  - Retrospective Studies
KW  - MedStar Harbor Hospital
KW  - Comparative Study
KW  - Journal Article
KW  - Video-Audio Media
N1  - Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006
N2  - BACKGROUND AND AIMS: Perforation during colonoscopy remains the most worrisome adverse event and usually requires urgent surgical rescue. The aim of this study was to evaluate the feasibility and effectiveness of endoscopic closure of full-thickness colonic perforations; CONCLUSION: Endoscopic suturing closure of colonic perforations is technically feasible, eliminates the need for rescue surgery, and appears more effective than closure with hemostatic endoscopic clips. Copyright (c) 2016. Published by Elsevier Inc; METHODS: We performed a retrospective analysis of all consecutive patients with endoscopically closed colonic perforations over the past 6 years (2009-2014). Colonic perforations were closed by using endoscopic clips or an endoscopic suturing device. Most patients were admitted for treatment with intravenous antibiotics and kept on bowel rest. If their clinical condition deteriorated, urgent surgery was performed. If patients remained stable, oral feeding was resumed, and patients were discharged with subsequent clinical and endoscopic follow-up; RESULTS: Twenty-one patients had iatrogenic colonic perforations closed with an endoscopic suturing device or endoscopic clips during the study period. Primary closure of a colonic perforation was performed with endoscopic clips in 5 patients and sutured with an endoscopic suturing device in 16 patients. All 5 patients after clip closure had worsening of abdominal pain and required laparoscopy (4 patients) or rescue colonoscopy with endoscopic suturing closure (1 patient). Two patients had abdominal pain after endoscopic suturing closure, but diagnostic laparoscopy confirmed complete and adequate endoscopic closure of the perforations. The other 15 patients did not require any rescue surgery or laparoscopy after endoscopic suturing. The main limitation of our study is its retrospective, single-center design and relatively small number of patients
UR  - https://dx.doi.org/10.1016/j.gie.2015.08.074
ER  -