TY - JOUR
T1 - Colonic endoscopic mucosal resection of large polyps
T2 - Is it safe in the very elderly?
AU - Gómez, Victoria
AU - Racho, Ronald G.
AU - Woodward, Timothy A.
AU - Wallace, Michael B.
AU - Raimondo, Massimo
AU - Bouras, Ernest P.
AU - Lukens, Frank J.
PY - 2014/8
Y1 - 2014/8
N2 - Background: Outcomes on colon endoscopic mucosal resection in the very elderly patient population are unknown. Aims: Aims of this study were to evaluate the outcomes and safety of colon endoscopic mucosal resection in this target population. Methods: Observational, retrospective study of patients ≥80 years of age that underwent colon endoscopic mucosal resection ≥2. cm. Demographics, American Society of Anesthesiologists classification, procedural data, and surgical treatment data were collected. Results: One-hundred-and-thirty-one colon endoscopic mucosal resections were performed on 99 patients ≥80 years of age with a mean age of 84. The majority of American Society of Anesthesiologists class was II. Mean lesion size was 3.3. cm (range, 2-12.5. cm), more procedures were performed in the right colon and adenoma/tubulovillous adenoma was the most common pathology. En bloc resection was performed on 26.7% of polyps (N= 35). Eight procedure-related adverse events (8/131, 6.1%) occurred. No anaesthesia related adverse events or deaths occurred. Six patients required a colonic operation, and overall, 94% of the patient cohort evaded a colon operation. Conclusions: Colon endoscopic mucosal resection in very elderly patients can be performed at experienced endoscopy centres with a low rate of complications and offers these patients a non-surgical option of management of colorectal lesions.
AB - Background: Outcomes on colon endoscopic mucosal resection in the very elderly patient population are unknown. Aims: Aims of this study were to evaluate the outcomes and safety of colon endoscopic mucosal resection in this target population. Methods: Observational, retrospective study of patients ≥80 years of age that underwent colon endoscopic mucosal resection ≥2. cm. Demographics, American Society of Anesthesiologists classification, procedural data, and surgical treatment data were collected. Results: One-hundred-and-thirty-one colon endoscopic mucosal resections were performed on 99 patients ≥80 years of age with a mean age of 84. The majority of American Society of Anesthesiologists class was II. Mean lesion size was 3.3. cm (range, 2-12.5. cm), more procedures were performed in the right colon and adenoma/tubulovillous adenoma was the most common pathology. En bloc resection was performed on 26.7% of polyps (N= 35). Eight procedure-related adverse events (8/131, 6.1%) occurred. No anaesthesia related adverse events or deaths occurred. Six patients required a colonic operation, and overall, 94% of the patient cohort evaded a colon operation. Conclusions: Colon endoscopic mucosal resection in very elderly patients can be performed at experienced endoscopy centres with a low rate of complications and offers these patients a non-surgical option of management of colorectal lesions.
KW - Colorectal lesions
KW - Complication rates
KW - Endoscopic mucosal resection
KW - Octogenarian patient
KW - Polypectomy
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U2 - 10.1016/j.dld.2014.03.012
DO - 10.1016/j.dld.2014.03.012
M3 - Article
C2 - 24731727
AN - SCOPUS:84904754683
SN - 1590-8658
VL - 46
SP - 701
EP - 705
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
IS - 8
ER -