title: Efficacy of Laparoscopic Primary Repair in the Treatment of Colonic Perforation After Colonoscopy: A Review of 40,127 Patients.
abstract: BACKGROUND
  In recent years, increasing colonoscopy use increases the incidence of colonic perforation. Colonic perforation during colonoscopy is a rare but extremely serious complication. Traditionally, the management of colonic perforation is explorative laparotomy with bowel resection. Treatment using laparoscopic approach is a novel approach, and has been reported in some recent literatures. Nowadays, the using of laparoscopic primary repair in treatment of colonoscopic perforations has not been confirmed. This study retrospectively reviewed our experiences in treating colonoscopic perforations by laparoscopic primary repair.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the safety and efficacy of the laparoscopic primary repair in the treatment of colonic perforations during colonoscopy.
  
  
  METHODS
  Between January 2003 and December 2014, data were collected retrospectively on all patients who underwent colonoscopy and compared the recovery parameters and morbidity of patients who underwent laparoscopic primary repair versus those who had open surgery.
  
  
  RESULTS
  A total of 40,127 colonoscopies were performed during the study period. There were 24 patients who underwent primary repair [13 underwent laparoscopic surgery (LS) and 8 underwent open surgery (OS)]. There were no demographic differences between the LS and OS groups (P>0.05). Compared with OS group, patients who underwent laparoscopic repair had a significantly shorter incision length (LS: 3.15±0.35 mm vs. OS: 12.60±2.87 mm, P=0.000), fewer blood loss (LS: 28.54±10.82 mL vs. OS: 159.25±46.90 mL, P=0.000), shorter postoperative hospital stay (LS: 8.31±1.93 d vs. OS: 12.38±1.41 d, P=0.000), and shorter postoperative fasting time (LS: 3.38±0.7 d vs. OS: 5.25±0.71 d, P=0.000). The operative time of LS group was a little longer than OS group, but there were no significant differences (LS: 86.31±22.22 min vs. OS: 75.125 ±14.24 min, P=NS).
  
  
  CONCLUSIONS
  Laparoscopic primary repair is safe and effective in resolving colonic perforation due to colonoscopy, and it might offer benefits over the open approach.
authors.affiliation: Departments of *Gastroenterological Surgery †Cardiovascular, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou ‡Department of Colorectal Surgery, The First Affiliated Hospital of GuangXi Medical University, Nanning, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Zhong
authors.forename: Chongrong
authors.initials: C
authors.lastname: Qiu
authors.forename: Chuanyuan
authors.initials: C
authors.lastname: Liu
authors.forename: Chuanfa
authors.initials: C
authors.lastname: Fang
authors.forename: Laiyang
authors.initials: L
authors.lastname: Xia
authors.forename: Junlin
authors.initials: J
authors.lastname: Liang
authors.forename: Seng
authors.initials: S
authors.lastname: Zhang
authors.forename: Lisheng
authors.initials: L
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000293:injuries*; D003108:Colonic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D015994:Incidence; D007416:Intestinal Perforation / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D013997:Time Factors