Adverse events related to colonoscopy: Global trends and future challenges

Su Young Kim, Hyun-Soo Kim, Hong Jun Park, Su Young Kim, Hyun-Soo Kim, Hong Jun Park

Abstract

Colonoscopy is a widely used method for diagnosing and treating colonic disease. The number of colonoscopies is increasing worldwide, and concerns about associated adverse events are growing. Large-scale studies using big data for post-colonoscopy complications have been reported. A colon perforation is a severe complication with a relatively high mortality rate. The perforation rate, as reported in large studies (≥ 50,000 colonoscopies) published since 2000, ranges from 0.005-0.085%. The trend in the overall perforation rate in the past 15 years has not changed significantly. Bleeding is a more common adverse event than perforation. Recent large studies (≥ 50,000 colonoscopies) have reported post-colonoscopy bleeding occurring in 0.001-0.687% of cases. Most studies about adverse events related to colonoscopy were performed in the West, and relatively few studies have been conducted in the East. The incidence of post-colonoscopy complications increases in elderly patients or patients with inflammatory bowel diseases. It is important to use a unified definition and refined data to overcome the limitations of previous studies. In addition, a structured training program for endoscopists and a systematic national management program are needed to reduce post-colonoscopy complications. In this review, we discuss the current trends in colonoscopy related to adverse events, as well as the challenges to be addressed through future research.

Keywords: Adverse events; Bleeding; Colonoscopy; Perforation; Post-colonoscopy.

Conflict of interest statement

Conflict-of-interest statement: No author has any personal or financial conflict of interest.

Figures

Figure 1
Figure 1
Yearly trends of perforation rates.
Figure 2
Figure 2
Yearly trends of bleeding rates.

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