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Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan.

Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. Research Abstract Details 

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  • Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. Abstract Text:

    keisei takuKeisei Taku,yasushi sanoYasushi Sano,kuang-i fuKuang-I Fu,yutaka saitoYutaka Saito,takahisa matsudaTakahisa Matsuda,toshio uraokaToshio Uraoka,takayuki yoshinoTakayuki Yoshino,yuichirou yamaguchiYuichirou Yamaguchi,mikio fujitaMikio Fujita,santa hattoriSanta Hattori,tsutomu ishikawaTsutomu Ishikawa,daizo saitoDaizo Saito,takahiro fujiiTakahiro Fujii,eizo kanekoEizo Kaneko,shigeaki yoshidaShigeaki Yoshida,

    BACKGROUND AND AIM: Colonic perforation is the serious accidental complication. The aim of this study is to analyze the clinical presentation and management of recent iatrogenic perforations during therapeutic colonoscopy. METHODS: Consecutive patients referred to four academic cancer centers in Japan were retrospectively reviewed using each center's endoscopy database of medical records. Data was obtained by means of an extensive data collection sheet. Since we evaluated the data including iatrogenic perforation during newly developed therapeutic procedure such as endoscopic submucosal dissection (ESD) or hemoclips, the collection of patient data was set from the period of the beginning of ESD technique in each hospital in this study. RESULTS: The overall rate of occurrence of perforation was 0.15% (23/15, 160). Perforation rate for EMR (0.58%) showed a significantly higher rate (P < 0.0001) than that for hot biopsy and polypectomy. The rate for ESD (14%) showed a markedly higher rate (P < 0.0001) than that for other standard procedures. Of those perforations, endoscopic clipping was performed in 56.5% of the patients, and conservative treatment was successful in 100% of the patients with successful closure. Both CT scan findings and serology results (WBC, CRP) after perforation were poor predictors for need for surgery as opposed to conservative management. CONCLUSIONS: Further improvements in EMR with special knife techniques are required to simply and safely remove large colorectal neoplasms, because perforation rate for ESD shows a markedly higher. Conservative management may be possible in patients who have undergone complete endoscopic clipping.

    Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. Publishing Authors By Initials

    k takuK Taku,y sanoY Sano,ki fuKI Fu,y saitoY Saito,t matsudaT Matsuda,t uraokaT Uraoka,t yoshinoT Yoshino,y yamaguchiY Yamaguchi,m fujitaM Fujita,s hattoriS Hattori,t ishikawaT Ishikawa,d saitoD Saito,t fujiiT Fujii,e kanekoE Kaneko,s yoshidaS Yoshida,

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    Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. Journal Published:

    PUBLICATION TYPE: Multicenter Study

    Journal: Journal of gastroenterology and hepatology

    VOLUME: 22

    Page Numbers: 1409-14

    Journal Abbreviation: J. Gastroenterol. Hepatol.

    ISSN: 0815-9319

    DAY: 25

    MONTH: 06

    YEAR: 2007

    Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. Information

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    LANGUAGE: eng

    NlmUniqueID: 8607909

    Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. Keywords Mesh Terms:

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    Grant and Affiliation Information for Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan.

    AFFILIATION: Division of Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan.

    Country: Australia

    Australia Research PublicationAustralia Research Publication

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    MEDLINETA: J Gastroenterol Hepatol

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