Victoria Gómez1, Ronald G Racho2, Timothy A Woodward3, Michael B Wallace3, Massimo Raimondo3, Ernest P Bouras3, Frank J Lukens3. 1. Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States. Electronic address: gomez.victoria@mayo.edu. 2. Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, United States. 3. Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
Abstract
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.
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.
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