内镜下修补术与外科开腹手术治疗迟发性结肠小穿孔的安全性与有效性:一项多中心回顾性研究OA

Objective To evaluate the safety and efficacy of endoscopic repair versus surgical laparotomy for delayed small iatrogenic colonic perforation.Methods A multicenter retrospective analysis was conducted on 18 patients who received endoscopic repair or surgical laparotomy for delayed small iatrogenic colonic perforation from April 2008 to July 2023,of whom 11 cases received endoscopic repair treatment(endoscopic group),and 7 cases received surgical laparotomy treatment(surgical group).The clinical data and therapeutic outcomes of patients between the two groups were compared.Results There were no significant differences in terms of age,gender,perforation diameter,causes of perforation,clinical manifestations,peak preoperative body temperature after perforation and white blood cell count between the two groups(P>0.05).The perforations of patients in the endoscopic group were mostly located in the right colon,while those of patients in the surgical group were mostly located in the left colon.Compared with the surgical group,patients in the endoscopic group had fewer surgical procedures(P=0.002),shorter length of hospital stay(P=0.002),lower hospitalization costs(P=0.027),lower medical complaint rate(P<0.001)and medical compensation rate(P<0.001),and higher hospitalization satisfaction rate(P<0.001).Conclusion Endoscopic repair for delayed small iatrogenic colonic perforation is comparable to surgical laparotomy in terms of safety and efficacy,and it also achieves higher inpatient satisfaction.