Department of Gastroenterology, Nishijin Hospital, Kyoto, Japan.
Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Indian J Gastroenterol. 2020 Dec;39(6):557-564. doi: 10.1007/s12664-020-01066-3. Epub 2020 Oct 15.
The number of colonoscopy (CS) for the elderly is increasing. There are only a few reports focusing on CS among the very elderly aged ≥ 90-y. We aimed to analyze the efficacy of CS and of colorectal cancer (CRC) for patients aged ≥ 90-y.
We retrospectively analyzed consecutive patients aged ≥ 90-y receiving CS at eight institutions from October 2016 to September 2017. Bowel preparation, complications, and endoscopic diagnosis were analyzed. The non-elderly group aged between 50-y and 64-y and elderly group aged between 65-y and 79-y were compared to very-elderly group aged ≥ 90-y. Through propensity score matching of sex and CS indications (symptomatic or asymptomatic), the number of CRC and the treatment in each group were analyzed.
We analyzed 125 patients receiving 154 colonoscopies (0.9%) in the very-elderly group from among 16,968 cases. Among 92 cases who received bowel-cleansing solution, good preparations were achieved in 94.5%. The rate of CS-related complications was 1.3% (2/154). The rate of CRC in the very-elderly group was 27.2% (34/125), higher than the non-elderly group (7.2%, 9/125, p < 0.01) and elderly group (8.8%, 11/125, p < 0.01). Therapeutic interventions for CRC in the very-elderly group were performed in 73.5% (24/34) patients. The mean survival of 12 patients with CRC resection was 788 days.
CS could be performed safely for the very elderly aged ≥ 90-y with careful considerations. CRC was confirmed to be more frequent in this group with over 70% of patients receiving appropriate therapeutic intervention.
结肠镜检查（CS）的数量在老年人中不断增加。仅有少数报告专门针对 90 岁以上的超高龄患者进行 CS。我们旨在分析 90 岁以上患者 CS 和结直肠癌（CRC）的疗效。
我们回顾性分析了 2016 年 10 月至 2017 年 9 月在 8 家机构接受 CS 的连续患者。分析了肠道准备、并发症和内镜诊断。将非老年组（50-64 岁）、老年组（65-79 岁）与超高龄组（≥90 岁）进行比较。通过性别和 CS 适应证（症状性或无症状性）的倾向评分匹配，分析每组 CRC 的数量和治疗方法。
我们从 16968 例患者中分析了 125 例接受 154 次 CS（0.9%）的超高龄患者。在 92 例接受肠道清洁剂的患者中，良好的准备率为 94.5%。CS 相关并发症的发生率为 1.3%（2/154）。超高龄组 CRC 的发生率为 27.2%（34/125），高于非老年组（7.2%，9/125，p<0.01）和老年组（8.8%，11/125，p<0.01）。超高龄组 CRC 的治疗干预措施在 73.5%（24/34）患者中进行。12 例 CRC 切除患者的平均生存时间为 788 天。
对于 90 岁以上的超高龄患者，CS 可以安全进行，但需谨慎考虑。该组 CRC 更为常见，超过 70%的患者接受了适当的治疗干预。
