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Published in:

01-09-2011

Colorectal endoscopic submucosal dissection for elderly patients at least 80 years of age

Authors: Toshio Uraoka, Reiji Higashi, Jun Kato, Eisuke Kaji, Hideyuki Suzuki, Shin Ishikawa, Mitsuhiro Akita, Tomoko Hirakawa, Shunsuke Saito, Keisuke Hori, Yoshiro Kawahara, Robert J. Mead, Kazuhide Yamamoto

Published in: Surgical Endoscopy | Issue 9/2011

Abstract

Background

Endoscopic submucosal dissection (ESD) has been used recently for successful en bloc resection of even large lesions, although no consensus appears in medical literature concerning its application to elderly patients. This prospective cohort study aimed to evaluate the efficacy and safety of colorectal ESD for patients 80 years of age or older.

Methods

Colorectal ESD procedure findings were compared with clinical outcomes, including associated complications and mortalities, for two age groups totaling 196 consecutive patients with 202 colorectal lesions. Of the 196 patients, 31 patients (16%) were 80 years of age or older (group E), and 165 patients (84%) were younger than 80 years (group Y).

Results

The median ages were 82 years in group E and 68 years in group Y. The frequency of chronic concomitant diseases was significantly higher in group E (65%) than in group Y (27%) (p = 0.003). No significant pressure decrease or need for oxygenation was observed in either group. In addition, groups E and Y did not differ significantly in terms of mean lesion sizes (40.9 vs. 39.7 mm) en bloc resection rates (84% vs. 93%), curative rates (78% vs. 84%), median procedure times (65 vs. 70 min), or associated complications (no perforation or delayed bleeding cases [0%] vs. 5 perforations [3%]) The median postprocedure hospitalization period was 3 days in both groups. Except for 10 cases requiring subsequent lymph node dissection surgery, follow-up colonoscopy examinations showed no recurrences or ESD-related mortalities in either group.

Conclusion

Colorectal ESD is a safe and effective treatment for elderly patients (age ≥ 80 years) despite a significantly higher frequency of chronic concomitant diseases than among younger patients.

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Title: Colorectal endoscopic submucosal dissection for elderly patients at least 80 years of age
Authors: Toshio Uraoka
Reiji Higashi
Jun Kato
Eisuke Kaji
Hideyuki Suzuki
Shin Ishikawa
Mitsuhiro Akita
Tomoko Hirakawa
Shunsuke Saito
Keisuke Hori
Yoshiro Kawahara
Robert J. Mead
Kazuhide Yamamoto
Publication date: 01-09-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 9/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-011-1660-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Colorectal endoscopic submucosal dissection for elderly patients at least 80 years of age

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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