Risk of perforation during colon procedures
Posted by medconsumers on March 1, 2003
What are the chances of having your colon punctured during a sigmoidoscopy or a colonoscopy? The question has been answered by a large study published last month in the Journal of the National Cancer Institute (JNCI, 2/3/03). Nearly two people out of every 1,000 who have a colonoscopy will suffer a perforation, and nearly one per 1,000 of those having a sigmoidoscopy. Out of every 1,000 people whose colons were perforated, 52 died as a result. People most likely to suffer a perforation are those over the age of 65 years who have two or more bowel-related conditions, such as diverticulosis and obstruction.
The new study, which drew from a random sample of the Medicare claims database, involved nearly 40,000 colonoscopies and over 35,000 sigmoidoscopies conducted between 1991 and 1998. All of these procedures were performed on people who did not have cancer. The research team led by Nicolle M. Gatto, Columbia University, New York, described their study as the largest to date that looked at major complications of sigmoidoscopy and colonoscopy performed in the “community.” Until now, information on the risks of both procedures came from clinical trials conducted at academic medical centers where experienced physicians perform them frequently. The new study provides a risk assessment that reflects the real world of medical practice. Generally speaking, the risk of perforation after colonoscopy decreased progressively during the eight-year period. Earlier studies have shown that the more a doctor performs procedures that require a certain level of skill, the lower the risk of complications.
Maryann Napoli, Center for Medical Consumers(c)