Is Inflammatory Bowel Disease a Risk Factor for Perforation During Diagnostic Colonoscopy? A Systematic Review and Meta-Analysis.

IF 2.5 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestive Diseases and Sciences Pub Date : 2025-09-13 DOI:10.1007/s10620-025-09392-2

Bachviet Nguyen, Stephanie Quon

{"title":"Is Inflammatory Bowel Disease a Risk Factor for Perforation During Diagnostic Colonoscopy? A Systematic Review and Meta-Analysis.","authors":"Bachviet Nguyen, Stephanie Quon","doi":"10.1007/s10620-025-09392-2","DOIUrl":null,"url":null,"abstract":"Purpose: Inflammatory bowel disease (IBD) may predispose patients to complications during colonoscopy, including colonic perforation. This systematic review and meta-analysis aimed to determine whether IBD is associated with an increased risk of colonic perforation compared to non-IBD patients during colonoscopy.Methods: We systematically searched MEDLINE, PubMed, and Embase from inception to June 2025 for studies comparing rates of colonic perforation during diagnostic, screening, or surveillance colonoscopy in IBD versus non-IBD patients. A random-effects meta-analysis was conducted to calculate pooled odds ratios (ORs), with between-study heterogeneity assessed using I2 statistics. Risk of bias was evaluated using the ROBINS-E tool.Results: Across eight retrospective cohort studies comprising over 9 million patients (686,258 with IBD), the pooled OR for colonic perforation in IBD patients during colonoscopy was 1.22 (95% CI 0.89-1.68; p = 0.2199), which did not reach statistical significance. Heterogeneity was high (I2 = 82.1%). Subgroup analysis for ulcerative colitis and Crohn's disease demonstrated a pooled OR of 1.05 (95% CI 0.32-3.40) and OR 1.16 (95% CI 0.71-1.92) respectively. Only one study was judged to have a low risk of bias across all domains.Conclusion: A diagnosis of IBD (either ulcerative colitis or Crohn's disease) is not significantly associated with an increased risk of colonic perforation during colonoscopy. Subgroup differences, study heterogeneity, and methodological limitations suggest a need for further research to better quantify this risk and guide procedural planning in IBD patients.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Diseases and Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10620-025-09392-2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Inflammatory bowel disease (IBD) may predispose patients to complications during colonoscopy, including colonic perforation. This systematic review and meta-analysis aimed to determine whether IBD is associated with an increased risk of colonic perforation compared to non-IBD patients during colonoscopy.

Methods: We systematically searched MEDLINE, PubMed, and Embase from inception to June 2025 for studies comparing rates of colonic perforation during diagnostic, screening, or surveillance colonoscopy in IBD versus non-IBD patients. A random-effects meta-analysis was conducted to calculate pooled odds ratios (ORs), with between-study heterogeneity assessed using I² statistics. Risk of bias was evaluated using the ROBINS-E tool.

Results: Across eight retrospective cohort studies comprising over 9 million patients (686,258 with IBD), the pooled OR for colonic perforation in IBD patients during colonoscopy was 1.22 (95% CI 0.89-1.68; p = 0.2199), which did not reach statistical significance. Heterogeneity was high (I² = 82.1%). Subgroup analysis for ulcerative colitis and Crohn's disease demonstrated a pooled OR of 1.05 (95% CI 0.32-3.40) and OR 1.16 (95% CI 0.71-1.92) respectively. Only one study was judged to have a low risk of bias across all domains.

Conclusion: A diagnosis of IBD (either ulcerative colitis or Crohn's disease) is not significantly associated with an increased risk of colonic perforation during colonoscopy. Subgroup differences, study heterogeneity, and methodological limitations suggest a need for further research to better quantify this risk and guide procedural planning in IBD patients.

查看原文本刊更多论文

炎性肠病是诊断性结肠镜检查穿孔的危险因素吗？系统回顾和荟萃分析。

目的：炎症性肠病（IBD）可能使患者在结肠镜检查时易发生并发症，包括结肠穿孔。本系统综述和荟萃分析旨在确定在结肠镜检查期间，与非IBD患者相比，IBD是否与结肠穿孔风险增加有关。方法：我们系统地检索了MEDLINE、PubMed和Embase，从成立到2025年6月，比较IBD与非IBD患者在诊断、筛查或监测结肠镜检查期间结肠穿孔率的研究。进行随机效应荟萃分析以计算合并优势比（or），并使用I2统计量评估研究间异质性。使用ROBINS-E工具评估偏倚风险。结果：8项回顾性队列研究共纳入900多万例IBD患者（686,258例），IBD患者结肠镜检查时结肠穿孔的合并OR为1.22 (95% CI 0.89-1.68; p = 0.2199)，无统计学意义。异质性高（I2 = 82.1%）。溃疡性结肠炎和克罗恩病的亚组分析显示合并OR分别为1.05 （95% CI 0.32-3.40）和1.16 （95% CI 0.71-1.92）。只有一项研究被判定在所有领域具有低偏倚风险。结论：在结肠镜检查中，IBD（溃疡性结肠炎或克罗恩病）的诊断与结肠穿孔的风险增加没有显著相关。亚组差异、研究异质性和方法局限性表明，需要进一步研究以更好地量化这种风险，并指导IBD患者的手术计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Digestive Diseases and Sciences 医学-胃肠肝病学

CiteScore

6.40

自引率

3.20%

发文量

420

审稿时长

1 months

期刊介绍： Digestive Diseases and Sciences publishes high-quality, peer-reviewed, original papers addressing aspects of basic/translational and clinical research in gastroenterology, hepatology, and related fields. This well-illustrated journal features comprehensive coverage of basic pathophysiology, new technological advances, and clinical breakthroughs; insights from prominent academicians and practitioners concerning new scientific developments and practical medical issues; and discussions focusing on the latest changes in local and worldwide social, economic, and governmental policies that affect the delivery of care within the disciplines of gastroenterology and hepatology.