Study | Predictors of need for early surgery (DNAER) |
Cho et al 2012 (colon)54 | Large perforation (OR, 9.25; 95% CI 1.85 to 46.20). Leucocytosis (OR 6.58; 95% CI 1.86 to 23.29). Fever (OR 5.05; 95% CI 1.05 to 24.28). Severe abdominal pain (OR 4.30; 95% CI 1.17 to 15.83). Large amount of peritoneal free air (OR 4.05; 95% CI1.40–11.71) |
Hagel et al 2012 (Oesophagus)13 | Large perforation length (13.4±8.8 mm, p<0.02), widths (5±4.5 mm) and area (97.6±149 mm2). Necrotic or soft inflammatory margins Significantly more OTSC (2.3±0.5, p=0.018) were tried Unfavourable anatomical site of the perforation |
Jovanovitc et al 2012 (colon)9 | Large defects located in angulated areas Stool contamination is present |
Hotta et al 2012 (colon)55 | Diffuse peritonitis Failure of endoscopic closure |
Fushihiro et al 2006 (colon)30 | >1 cm Significant leakage/poor bowel preparation Inexperienced endoscopist Clinical deterioration |
Yang et al 2010 (colon)56 | Peritoneal irritation Failure of endoscopic clipping Age >65 years Perforations above the rectum |
DNAER, do not attempt endoscopic repair.