The risk for developing complications during screening colonoscopy and the 4 weeks following the procedure is low, according to the results of a German prospective study.
Because the German health care system has only routinely documented complications that occur immediately after colonoscopy, the known complication rate of 2.8 per 1,000 colonoscopies could be an underestimate, as the symptoms of complications like perforations or bleeding could be delayed. Therefore, researchers from the German Cancer Research Center and the Saarland cancer registry assessed complications occurring within 4 weeks in 5,527 patients (median age, 61 years; 52% women) who underwent screening colonoscopy at 26 practices in Saarland, Germany, between 2010 and 2013.
Of the 5,252 patients who provided complete information, 43 (0.82%) reported they had complications, but only 16 cases of bleeding (0.3%) and four perforations (0.08%) were medically confirmed by a physician, corresponding to an overall complication rate of 0.38%.
Bleeding led to five (0.095%) hospitalizations and perforation led to two (0.04%) hospitalizations.
Almost all complications occurred in patients who had neoplasms or other polyps removed. Three patients died within 3 months of colonoscopy, but none of the deaths were related to the procedure.
Most of those with bleeding/hemorrhage were unaware that the complications were reported by their physician.
Overall, physicians confirmed 10 cases of bleeding/hemorrhage and two perforations, corresponding to a complication rate of 0.38%.
The investigators concluded that when considering the 4-week period after colonoscopy, the complication rate remains low, especially in patients without colorectal neoplasms.
“This underlines the safety of screening colonoscopy in a setting with adequate quality assurance such as the German screening colonoscopy program,” they wrote. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.