title: Iatrogenic colonic perforation: repair using laparoscopic technique.
abstract: BACKGROUND
  Iatrogenic colonic perforation is a rare complication of colonoscopies. Nowadays, there are still no specific guidelines for the optimal management of these complications (open surgery with colonic resection and anastomosis or colonic diversion, primary repair, endoscopic clips, nonoperative management, and laparoscopic approach).
  
  
  METHODS
  A retrospective analysis of 9 patients operated on for iatrogenic colonic perforations (February 2002 to August 2009) is reported. These were treated, in 6 cases, with laparoscopic colorrhaphy, in 2 cases with laparoscopic colonic resection and anastomosis (with 1 temporary ileostomy), and the last patient with laparoscopic Hartmann procedure.
  
  
  RESULTS
  All patients underwent successful laparoscopic treatment, with no mortality.
  
  
  CONCLUSIONS
  Laparoscopic treatment of iatrogenic colonic perforations is a compromise between risks of nonoperative therapy and invasive surgery. According to our early experience, laparoscopic approach could be used as first choice in the management of these complications. Further studies are necessary for full validation of this approach.
authors.affiliation: Department of General Surgery, Monaldi Hospital via L. Bianchi, Napoli, Italy. lumira@email.it
authors.forename: Lucia
authors.initials: L
authors.lastname: Miranda
authors.forename: Anna
authors.initials: A
authors.lastname: Settembre
authors.forename: Domenico
authors.initials: D
authors.lastname: Piccolboni
authors.forename: Pietro
authors.initials: P
authors.lastname: Capasso
authors.forename: Francesco
authors.initials: F
authors.lastname: Corcione
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000293:injuries* / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D015994:Incidence; D007416:Intestinal Perforation / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome