title: Optimizing time management after perforation by colonoscopy results in better outcome for the patients.
abstract: OBJECTIVE
  Perforation during colonoscopy is a rare but severe complication. The aim of this study was to assess the time management and laparoscopic therapy of this complication and to evaluate patient outcomes.
  
  
  METHODS
  A retrospective analysis was done on 15 patients operated for a perforation from colonoscopy between January 2000 and December 2006.
  
  
  RESULTS
  Three perforations occurred during diagnostic and 12 perforations during interventional colonoscopy. Two perforations occurred as transmural thermal injury to the colon wall. Peritonitis was found in 4 cases and significantly correlated with the mean time between perforation and operation. Twelve perforations were oversewn laparoscopically and 3 perforations were oversewn by laparotomy. After laparoscopic treatment, hospital stay was significantly shorter than after laparotomy. One patient had a postoperative wound infection, mortality was 0%.
  
  
  CONCLUSIONS
  Laparoscopic oversewing is a safe and effective method in the treatment of perforation from colonoscopy. Optimizing the time range between perforation and laparoscopic therapy results in a better outcome for the patients.
authors.affiliation: Diakonie Hospital Mannheim, Surgical Department, Speyerer Strasse 91- 3, 68163 Mannheim, Germany. b.rumstadt@diako-ma.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Rumstadt
authors.forename: Dieter
authors.initials: D
authors.lastname: Schilling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D017748:Time Management; D016896:Treatment Outcome