COLONOSCOPIC PERFORATION INCIDENCE AND RISK FACTORS IN RAJAVITHI TRAINING HOSPITAL.

Background: Colonoscopy become a common procedure to diagnosis and treatment pathological conditions in the colon. Colonoscopic perforation is one of the most serious complications during colonoscopy thus, it may cause high morbidity and mortality. Objective: This study aims to determine incidence and risk factors of colonoscopic perforation in a training hospital. Materials and Methods: A retrospective review of medical records was performed for patients undergoing colonoscopy in Rajavithi hospital between 2009 and 2019. The patient's demographic data, indication for colonoscopy, quality of bowel preparation, endoscopic procedure, perforation, diagnostic was recorded. All statistic process was done by IBM SPSS version 20.0 Results: Between 2009 and 2019 there were 12,239 colonoscopy performed and 2,182 colonoscopy was excluded due to exclusion criteria. In total 0.71% (71/10,057) colonoscopic perforation occurred. In univariate analysis was reveal history of previous surgery, anesthesia, endoscopist, indication for colonoscopy, and endoscopic procedures were statistically significant to colonoscopic perforation. Multivariate logistic regression analysis reveal that previous gynecologic surgery (OR 41.1, p-value < 0.001, 95% C.I. 16.40-102.73), general anesthesia (OR 7.74, p-value 0.016, 95% C.I. 1.46-40.97), trainee (OR 20.74, p-value < 0.001, 95% C.I. 11.25-38.35) and polypectomy (OR 6.08, p-value < 0.001, 95% C.I. 3.15-11.70), EMR (OR 23.32, p-value <0.001, 95% C.I. 6.02-90.41) and ESD (OR 89.99, p-value < 0.001, 95% C.I. 12.74-135.46) were significant. Conclusion: Patients tend to have a higher colonoscopic perforation rate when (1) they have a history of previous gynecological surgery or (2) general anesthesia (3) the colonoscopy to be performed by a trainee or (4) polypectomy or EMR or ESD to be performed. [ABSTRACT FROM AUTHOR]