Davis-Yadley Ashley H, Lipka Seth, Rodriguez Andrea C, Nelson Kirbylee K, Doraiswamy Vignesh, Rabbanifard Roshanak, Kumar Ambuj, Brady Patrick G
Departments of Internal Medicine, University of South Florida, 17 Davis Blvd, Suite 308, Tampa, FL 33606, USA.
Digestive Diseases and Nutrition, University of South Florida, Tampa, FL, USA.
Therap Adv Gastroenterol. 2016 Mar;9(2):169-79. doi: 10.1177/1756283X15614517.
Single balloon enteroscopy (SBE) is an important tool in the management of small bowel disease with limited data available on its performance in the elderly. We aimed to evaluate the safety, efficacy, diagnostic and therapeutic outcomes of SBE in the elderly.
A retrospective review was performed on 366 patients undergoing 428 SBEs from 2010 to 2014. Patients were divided into different age groups: control <55, 55-64, 65-74 and ⩾75 years. Data on comorbidities, complications, findings, diagnostic and therapeutic yield were compared between groups.
Anterograde and retrograde SBE were performed in 340 and 49 patients, respectively, with 63 patients requiring more than 1 procedure. Diagnostic yield was significantly higher for age ⩾75 years compared with <55, 66.3% versus 50%, odds ratio (OR) 1.97 [95% confidence interval (CI) 1.14-3.41]. Therapeutic yield was significantly higher in all three older age groups compared with <55 years, 20.3%: 55-64 years, 44.4%, OR 3.13(95% CI 1.7-5.78); 65-74 years, 42%, OR 2.84 (95% CI 1.59-5.06); and >75 years, 47.5%, OR 3.55 (95% CI 1.96-6.43). No significant difference was seen between age groups in complications or failures. Our overall complication rate was 2.3% with 5 minor and 5 major complications. There was a higher yield of angioectasias in the elderly. Argon plasma coagulation (APC) and multipolar electrocoagulation were used more often in older age groups.
SBE is safe in elderly patients and delivers higher diagnostic and therapeutic yields compared to younger patients. The elderly are more likely to have angioectasias and undergo APC and electrocoagulation.
单气囊小肠镜检查（SBE）是诊治小肠疾病的一项重要工具，但关于其在老年人中的应用表现的数据有限。我们旨在评估SBE在老年人中的安全性、有效性、诊断及治疗效果。
对2010年至2014年期间接受428例SBE检查的366例患者进行回顾性分析。患者被分为不同年龄组：对照组年龄＜55岁、55 - 64岁、65 - 74岁及≥75岁。比较各组间合并症、并发症、检查结果、诊断及治疗成功率的数据。
分别对340例和49例患者进行了顺行和逆行SBE检查，63例患者需要进行不止一次检查。与年龄＜55岁的患者相比，年龄≥75岁患者的诊断成功率显著更高，分别为66.3%和50%，优势比（OR）为1.97[95%置信区间（CI）1.14 - 3.41]。与年龄＜55岁的患者相比，所有三个老年组的治疗成功率均显著更高，分别为20.3%：55 - 64岁组为44.4%，OR为3.13（95%CI 1.7 - 5.78）；65 - 74岁组为42%，OR为2.84（95%CI 1.59 - 5.06）；≥75岁组为47.5%，OR为3.55（95%CI 1.96 - 6.43）。各年龄组在并发症或检查失败方面未见显著差异。我们的总体并发症发生率为2.3%，其中5例为轻微并发症，5例为严重并发症。老年人血管扩张症的检出率更高。氩离子凝固术（APC）和多极电凝术在老年组中使用更为频繁。
SBE在老年患者中是安全的，与年轻患者相比，其诊断和治疗成功率更高。老年人更易出现血管扩张症，并接受APC和电凝术治疗。
