Perforation rate in CT colonography: a systematic review of the literature and meta-analysis.

Purpose: The primary aim was to assess the perforation rate of CTC; the secondary aim was to identify potential clinical/technical predictors of this complication.Methods: Methods for analysis were based on PRISMA (preferred reporting items for systematic reviews and meta-analyses). From the selecte...

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Publicado en:European Radiology Vol. 24; no. 7; pp. 1487 - 1497
Autores principales: Bellini, Davide, Rengo, Marco, De Cecco, Carlo Nicola, Iafrate, Franco, Hassan, Cesare, Laghi, Andrea
Formato: meta analysis research systematic review Journal Article
Publicado: Springer Nature Jul2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2014
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      pub: Springer Nature
      place: New York, New York
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        atl: Perforation rate in CT colonography: a systematic review of the literature and meta-analysis.
      aug:
        au:
          Bellini, Davide
          Rengo, Marco
          De Cecco, Carlo Nicola
          Iafrate, Franco
          Hassan, Cesare
          Laghi, Andrea
        affil: Department of Radiological Sciences, Oncology and Pathology, 'Sapienza' University of Rome, ICOT Hospital, Via Franco Faggiana 34, 04100, Latina, Italy, bellinidavide29@gmail.com.
      sug:
        subj:
          Colon Injuries
          Colonography, Computed Tomographic Adverse Effects
          Colorectal Neoplasms Radiography
          Intestinal Perforation Epidemiology
          Human
          Meta Analysis
          Systematic Review
          World Health
      ab: Purpose: The primary aim was to assess the perforation rate of CTC; the secondary aim was to identify potential clinical/technical predictors of this complication.Methods: Methods for analysis were based on PRISMA (preferred reporting items for systematic reviews and meta-analyses). From the selected studies, the rate of CTC perforation and patient/technical characteristics potentially associated with this event were extracted. Forest plots showing individual and pooled estimates of the perforation rate were obtained for all analyses. I(2) was used to evaluate heterogeneity between studies.Results: Eleven articles out of the 187 initially identified were selected for the analysis (103,399 patients). There were 29,048 (28%) asymptomatic individuals and 30,773 (30%) symptomatic patients; this characteristic was not reported in the remaining subjects (42%). Colon distension was obtained manually in 69,222 (67%) and using an automated carbon dioxide insufflator in 26,479 (26%) patients; in the remaining 7% of patients, this information was missing. Twenty-eight colonic perforations were reported, with the CTC perforation rate estimated to be 0.04% (95% CI. 0.00-0.10), 19-fold higher in symptomatic than in screening subjects (OR: 19.2, CI 3.3-108 and P = 0.001). The surgical rate was 0.008%. No CTC-related deaths were reported.Conclusions: The perforation rate in CTC is very low, particularly considering asymptomatic individuals.Key Points: • This is the first meta-analysis on this topic, based on 100,000 patients. • The CTC-related colorectal perforation rate is 0.04%, 0.02% in asymptomatic subjects. • The CTC-induced surgery rate is 0.008% (1:12,500). • The perforation rate in CTC is low, particularly in average-risk, asymptomatic individuals.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        Journal Article
      ougenre: Article
    language: English
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