Endoscopic Closure vs. Surgery for Colonic Perforations

Endoscopic closure may be a viable first-line approach for select iatrogenic colonic perforations.

No difference in treatment success between endoscopic closure and surgery (RR 1.00, 95% CI 0.94-1.06).
Endoscopy was generally used for smaller, immediately recognized injuries, while surgery was preferred for larger, delayed presentations.
In ideal candidates (perforations <2 cm with no peritonitis), endoscopy could shorten hospital stays.

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