Published online Jan 14, 2019. doi: 10.3748/wjg.v25.i2.190
Peer-review started: September 28, 2018
First decision: October 26, 2018
Revised: November 22, 2018
Accepted: November 30, 2018
Article in press: November 30, 2018
Published online: January 14, 2019
Processing time: 108 Days and 22.6 Hours
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.
Core tip: Although colonoscopy-related adverse events rarely occur and the need for colonoscopy is increasing, the proportion of subjects with risk factors is increasing. Recently, the perforation rate, as reported in large studies, ranges from 0.005-0.085%. The perforation probability after colonoscopy does not decrease over time in either the West or the East. Other studies have reported post-colonoscopy bleeding occurring in 0.001-0.687% of cases. In this review article, we discuss the current trends in post-colonoscopy complications, as well as the challenges to be addressed through future research.