Colon perforations complicating colonoscopies: what is the best known evidence for prevention?

Colon perforations complicating colonoscopies: what is the best known evidence for prevention?

Collection:
Health Policy and Services Research
Series Title(s):
Pennsylvania patient safety advisory
Contributor(s):
Pennsylvania. Patient Safety Authority.
ECRI (Organization)
Institute for Safe Medication Practices.
Publication:
[Harrisburg, Pa.] : Pennsylvania Patient Safety Authority, c2008
Language(s):
English
Format:
Text
Subject(s):
Colon -- injuries
Colonoscopy -- adverse effects
Colonoscopy -- methods
Intestinal Perforation -- etiology
Intestinal Perforation -- prevention & control
Pennsylvania
United States
Genre(s):
Technical Report
Abstract:
A systematic qualitative review was done of all modifiable risk factors reported in the medical literature to have a possible association with perforations associated with colonoscopies and of the recommendations in the medical literature and clinical practice guidelines for reducing the risks of these perforations. Inclusion criteria were defined a priori. Ten databases were searched, plus the National Guideline Clearinghouse and the National Quality Measures Clearinghouse. Only three clinical studies specifically addressed modifiable risk factors for perforations associated with colonoscopies. Another four publications addressed recommendations for avoiding perforation. The modifiable risk factors identified were the use of pediatric colonoscope in an adult and the duration and strength of coagulation. Seventeen recommendations were reported for reducing perforation rates associated with colonoscopy. The evidence used to support these recommendations was weak. The recommendations have not been definitively shown to reduce the risk of colon perforation. Critical prospective reporting and comparisons may be beneficial in providing sufficient evidence to support current conclusions.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
NLM Unique ID:
101569753 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/101569753