摘要
AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training Center in Thailand. METHODS： All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients＇ characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS： A total of 17357 endoscopic procedures of the colon （13 699 colonoscopies and 3658 flexible sigmoidoscopies） were performed in Siriraj hospital over a 9-year period. Fifteen patients （0.09%） had CP： 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon （80%）, followed by the transverse colon （13%）. Perforations were caused by direct trauma from either the shaft or the tip of the endoscope （n = 12,80%） and endoscopic polypectomy （n = 3, 20%）. All patients with CP underwent surgical management： primary repair （27%） and bowel resection （73%）. The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION： CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.
瞄准：决定 colonoscopic 穿孔(CP ) 的发生，并且从在泰国训练中心的世界肠胃病学组织(WGO ) 内视镜检查法与 CP 评估病人的临床的调查结果，管理和结果。方法：所有 colonoscopies 和 sigmoidoscopies 在内视镜的单位表现在 1999 和 2007 之间，药 Siriraj 医院的教师， Mahidol 大学，曼谷被考察。CP，病人的特征，内视镜的信息， intra 起作用的调查结果，管理和结果的发生被分析。结果：结肠(13699 colonoscopies 和 3658 灵活 sigmoidoscopies ) 的 17357 内视镜的过程的一个总数在 9 年的经期上在 Siriraj 医院里被执行。十五个病人(0.09%) 有 CP：14 从结肠镜检查并且 1 从乙状结肠镜检查。穿孔的最普通的地点在 S 字形的冒号(80%) ，由横向的冒号(13%) 列在后面。穿孔被直接损伤从柄或内诊镜的尖端引起(n = 12， 80%) 并且内视镜的 polypectomy (n = 3， 20%) 。有 CP 的所有病人经历了外科的管理：主要修理(27%) 和肠切除术(73%) 。死亡率是 13% ，手术后的复杂并发症率是 53% 。结论：CP 是稀罕却严肃的复杂并发症追随者结肠镜检查和乙状结肠镜检查，与病态和死亡的高率。CP 的发生是 0.09% 。外科仍然是 CP 管理的支柱。
