Table of Contents Author Guidelines Submit a Manuscript
Minimally Invasive Surgery
Volume 2013, Article ID 823506, 5 pages
http://dx.doi.org/10.1155/2013/823506
Clinical Study

Laparoscopic Primary Colorrhaphy for Acute Iatrogenic Perforations during Colonoscopy

1Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, The University of Texas Medical School at Houston, Houston, TX 77030, USA
2Colorectal Surgical Associates, LLP, Ltd., Houston, TX, USA

Received 26 October 2012; Accepted 11 December 2012

Academic Editor: Peng Hui Wang

Copyright © 2013 Eric M. Haas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. We present our experience with laparoscopic colorrhaphy as definitive 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. The perforations were secondary to direct trauma or thermal injury and were localized to the sigmoid or cecum . None of the patients required surgical resection, diversion, or conversion to an open procedure. No intra- or postoperative complications were encountered. The mean length of hospital stay was 3.8 ± 0.8 days (range: 3–5). There 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.