Polypectomy Perforation , Clipping Najaf April 25-26, 2011 Fayez Sandouk MD FRCP Chairman GI Scientific Council Ministry of Health , Syria Chairman YCP in AMAGE, Coordinator OMED/WEO Outreach DVD Program Damascus – Syria Master für Startseite

Recurrent Rectal Bleeding Polypectomy Perforation , Clipping 34 YO Female Recurrent Rectal Bleeding

Polypectomy Perforation , Clipping Descending Colon Wide Base

Polypectomy Perforation , Clipping Descending Colon Injection

Polypectomy Perforation , Clipping Descending Colon Cut & Perforation

Polypectomy Perforation , Clipping Descending Colon Clipping

Polypectomy Perforation , Clipping Descending Colon Basket

Polypectomy Perforation , Clipping

Polypectomy Perforation , Clipping

Polypectomy Perforation , Clipping The risk of perforation in Therap. Colo is 2% Metallic Repair if failed, then for Marking for surgery Endoscopic closure of large colonic perforations using an over-the-scope clip: a randomized controlled porcine study in porcine models. Germany. von Renteln D, et al Endoscopy. 2009 Jun;41(6):558-9. closure with endoluminal clips . Italy . JSLS. 2009 Jan-Mar;13(1):69-72. Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: a literature review.Italy J Dig Dis. 2010 Feb;11(1):12-8. 2008 Dec;12(4):315-21; discussion 322. Epub 2008 Nov 18. Digestion. 2008;78(4):218-23. Epub 2009 Jan 13. Surg Endosc. 2008 Sep;22(9):2072-4. Epub 2008 Jul 2. Safety & Efficay ? Gastrointest Endosc. 2008 Aug;68(2):324-32. 4 cm perforation Am J Gastroenterol. 2000 Dec;95(12):3418-22. Endoscopy. 2009 Nov;41(11):941-51 Netherland: The frequency of perforation was found to be 1 in 1400 for overall colonoscopies and 1 in 1000 for therapeutic colonoscopies. Advanced age, female sex, the presence of multiple co-morbidities, diverticulosis, and bowel obstruction have been shown to increase the risk of perforation. The decision between surgery and nonoperative treatment will depend on the type of injury, the quality of bowel preparation, the underlying colonic pathology, and the clinical stability of the patient.

Clip closure at 1-cm intervals is sufficient for successful closure of a 2-cm colon perforation. USA Gastrointest Endosc. 2006 Dec;64(6):989-97. Duration

Perforation occurred in 10.4 % of the ESD procedures. japan Endoscopy. 2009 Sep;41(9):758-61.

Surg Endosc. 2008 Jun;22(6):1500-4. Meinhaeim METHODS: In this series, 7589 colonoscopies were performed over a 34-month period in a tertiary-level referral center. Three perforations occurred during 5413 diagnostic colonoscopies. Therapeutic colonoscopy was under taken in 2176 patients, resulting in a total of 27 perforations. Out of 30 patients with colonic perforation, five patients underwent operative management and 25 patients were subsequently treated nonoperatively. RESULTS: In 27 patients, endoscopic application of inert metallic clips was used for closure of iatrogenic perforation. Twenty-five of these patients were treated non-operatively, while two patients underwent surgery. The mean postoperative length of hospitalization for patients was 12.2 days, compared to 3.5 days for patients treated conservatively.

Endoscopy. 2009 Nov;41(11):941-51 Netherland: The frequency of perforation was found to be 1 in 1400 for overall colonoscopies and 1 in 1000 for therapeutic colonoscopies. Advanced age, female sex, the presence of multiple co-morbidities, diverticulosis, and bowel obstruction have been shown to increase the risk of perforation. The decision between surgery and nonoperative treatment will depend on the type of injury, the quality of bowel preparation, the underlying colonic pathology, and the clinical stability of the patient.

Thanks Fayez