New technique effective in closing accidental colonoscopy wounds

WASHINGTON, D.C. -- To prevent colon cancer, the second leading cause of United States cancer deaths, the American Cancer Society recommends that after age 50 people undergo colonoscopies every ten years to detect signs of that disease either actual tumors or precancerous polyps.

But in one out of every 1,000 to 2,000 colonoscopies, doctors inadvertently perforate or puncture the colon. Most of these patients need urgent surgery to close the wound and spend 10 days in the hospital. One in 10 dies, usually because delays in closing perforations allow colon contents to leak into the abdominal cavity, causing deadly conditions such as peritonitis and sepsis.

Now, however, in a series of animal studies, researchers at the University of Texas Medical Branch at Galveston (UTMB) have developed a technique for closing perforations promptly after they are recognized by using clips or sutures that can be inserted through the anus via endoscope, thus avoiding invasive surgery. Similar clips and sutures have been used for some time by surgeons performing minimally invasive laparoscopic procedures including several gynecological operations and other procedures such as gall bladder removal.

Today [Wednesday, May 23, 2007] at the annual meeting of the American Society of Gastrointestinal Endoscopy, UTMB professor G.S. Raju, the principal investigator for the wound-repair studies, presented a summary of his experimental endoscopic research over the last three years.

Working with pigs as an experimental model, Raju and his team first successfully closed colon perforations of less than one inch with small metal clips inserted via endoscopes.

During colonoscopies, surgeons accidentally may cause two principal types of perforations, Raju explained. One results from over-stretching the colon, the other from removal of polyps. (Incomplete removal of polyps may cause adhesions, in which the remaining portion of the polyp sticks

Contact: Tom Curtis
University of Texas Medical Branch at Galveston

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