Korean J Gastrointest Endosc.  2009 Jun;38(6):323-331.

The Feasibility and Safety of Endoscopic Submucosal Dissection for Gastric Neoplasm in Elderly Korean Patients

Affiliations
  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. swjeon@knu.ac.kr

Abstract

BACKGROUND/AIMS: Elderly patients often have high operative risk due to their comorbid diseases, and the feasibility of performing endoscopic submucosal dissection (ESD) for such patients should be investigated. The aim of this study is to evaluate the efficacy and safety of performing ESD in elderly patients.
METHODS
From 2005 to 2007, 269 patients with gastric neoplasm were treated by ESD in our hospital. These patients were divided into the elderly patients who were 65 years of age or older and the younger patients. The number of enrolled elderly patients was 123. The en bloc complete resection rate and the complications were assessed and compared with those of the younger patients.
RESULTS
The average age of the old age group of patients was 71.1. Of these patients, 53.7% had comorbid diseases and 51.2% revealed adenocarcinoma. The en bloc plus complete resection rate was 85.4%. Perforation during ESD occurred in 4.1% of the patients, and this was immediately closed with endoclips and then it was managed by conservative medical treatment. Bleeding occurred in 17.9% and there were no patients with severe bleeding. The en bloc plus complete resection rate and the complication rate for the elderly patients were not significantly different from those of the younger patients.
CONCLUSIONS
The present study shows that ESD could be a safe and reliable treatment for gastric neoplasms in elderly patients.

Keyword

Elderly patient; Gastric neoplasm; Endoscopic submucosal dissection

MeSH Terms

Adenocarcinoma
Aged
Hemorrhage
Humans
Stomach Neoplasms
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