Surgical Management and Outcomes of 165 Colonoscopic Perforations From a Single Institution

BACKGROUND Increasing use of colonoscopy is making iatrogenic perforations more common. We herein present our experience with operative management of colonoscopic-related perforations. DESIGN Retrospective review (1980-2006). SETTING Tertiary referral center. PATIENTS A total of 258 248 colonoscopies performed in patients, from which we identified 180 iatrogenic perforations (incidence, 0.07%). Of these, 165 perforations were managed operatively. RESULTS Patients underwent primary repair (29%), resection with primary anastomosis (33%), or fecal diversion (38%). Patients presenting within 24 hours (78%) were more likely to have minimal peritoneal contamination (64 patients [50%] vs 6 [17%]; P = .01) and to undergo primary repair or resection with anastomosis (86 [67%] patients vs 13 [36%]; P