Iatrogenic Colonic Perforation: Repair Using Laparoscopic Technique

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.