Abstract
Background and Aim: Endoscopic submucosal dissection (ESD) is gaining acceptance among endoscopists for its efficacy, especially in Japan. Elderly patients often have operative risk due to comorbid diseases, and the feasibility of this treatment for such patients should be investigated. The aim of this study is to evaluate the efficacy and safety of ESD in elderly patients. Methods: Among 308 gastric neoplasms treated by ESD from 2000 to 2004 in one hospital, 49 lesions were discovered in 42 elderly patients who were 75 years of age or older. Indication criteria for ESD were gastric neoplasms with no apparent massive submucosal invasion diagnosed by endoscopy. The en bloc plus R0 resection rate and complications were assessed in comparison with younger patients. Results: The average age of the patients was 78.9 years (range 75-88 years). Of these patients, 24 (57%) had comorbid diseases. The complete en bloc plus R0 resection rate was 96% (47/49). Postoperative bleeding requiring emergency endoscopy occurred in three patients (7%). Perforation during ESD occurred in one patient (2%), and was immediately closed with endoclips and managed by conservative medical treatment. The en bloc plus R0 resection rate and complication rate in elderly patients were not significantly different from those of younger patients. Conclusions: These results indicate that ESD could be a safe and reliable treatment for gastric neoplasms in elderly patients.
| Original language | English |
|---|---|
| Pages (from-to) | 311-314 |
| Number of pages | 4 |
| Journal | Journal of Gastroenterology and Hepatology (Australia) |
| Volume | 22 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2007 |
| Externally published | Yes |
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Keywords
- Elderly
- Endoscopic submucosal dissection (ESD)
- Endoscopic treatment
- Gastric adenoma
- Gastric neoplasms
ASJC Scopus subject areas
- Gastroenterology
- Hepatology
Cite this
Technical feasibility of endoscopic submucosal dissection for gastric neoplasms in the elderly Japanese population. / Kakushima, Naomi; Fujishiro, Mitsuhiro; Kodashima, Shinya; Muraki, Yosuke; Tateishi, Ayako; Yahagi, Naohisa; Omata, Masao.
In: Journal of Gastroenterology and Hepatology (Australia), Vol. 22, No. 3, 2007, p. 311-314.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Technical feasibility of endoscopic submucosal dissection for gastric neoplasms in the elderly Japanese population
AU - Kakushima, Naomi
AU - Fujishiro, Mitsuhiro
AU - Kodashima, Shinya
AU - Muraki, Yosuke
AU - Tateishi, Ayako
AU - Yahagi, Naohisa
AU - Omata, Masao
PY - 2007
Y1 - 2007
N2 - Background and Aim: Endoscopic submucosal dissection (ESD) is gaining acceptance among endoscopists for its efficacy, especially in Japan. Elderly patients often have operative risk due to comorbid diseases, and the feasibility of this treatment for such patients should be investigated. The aim of this study is to evaluate the efficacy and safety of ESD in elderly patients. Methods: Among 308 gastric neoplasms treated by ESD from 2000 to 2004 in one hospital, 49 lesions were discovered in 42 elderly patients who were 75 years of age or older. Indication criteria for ESD were gastric neoplasms with no apparent massive submucosal invasion diagnosed by endoscopy. The en bloc plus R0 resection rate and complications were assessed in comparison with younger patients. Results: The average age of the patients was 78.9 years (range 75-88 years). Of these patients, 24 (57%) had comorbid diseases. The complete en bloc plus R0 resection rate was 96% (47/49). Postoperative bleeding requiring emergency endoscopy occurred in three patients (7%). Perforation during ESD occurred in one patient (2%), and was immediately closed with endoclips and managed by conservative medical treatment. The en bloc plus R0 resection rate and complication rate in elderly patients were not significantly different from those of younger patients. Conclusions: These results indicate that ESD could be a safe and reliable treatment for gastric neoplasms in elderly patients.
AB - Background and Aim: Endoscopic submucosal dissection (ESD) is gaining acceptance among endoscopists for its efficacy, especially in Japan. Elderly patients often have operative risk due to comorbid diseases, and the feasibility of this treatment for such patients should be investigated. The aim of this study is to evaluate the efficacy and safety of ESD in elderly patients. Methods: Among 308 gastric neoplasms treated by ESD from 2000 to 2004 in one hospital, 49 lesions were discovered in 42 elderly patients who were 75 years of age or older. Indication criteria for ESD were gastric neoplasms with no apparent massive submucosal invasion diagnosed by endoscopy. The en bloc plus R0 resection rate and complications were assessed in comparison with younger patients. Results: The average age of the patients was 78.9 years (range 75-88 years). Of these patients, 24 (57%) had comorbid diseases. The complete en bloc plus R0 resection rate was 96% (47/49). Postoperative bleeding requiring emergency endoscopy occurred in three patients (7%). Perforation during ESD occurred in one patient (2%), and was immediately closed with endoclips and managed by conservative medical treatment. The en bloc plus R0 resection rate and complication rate in elderly patients were not significantly different from those of younger patients. Conclusions: These results indicate that ESD could be a safe and reliable treatment for gastric neoplasms in elderly patients.
KW - Elderly
KW - Endoscopic submucosal dissection (ESD)
KW - Endoscopic treatment
KW - Gastric adenoma
KW - Gastric neoplasms
UR - http://www.scopus.com/inward/record.url?scp=33846939038&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33846939038&partnerID=8YFLogxK
U2 - 10.1111/j.1440-1746.2006.04563.x
DO - 10.1111/j.1440-1746.2006.04563.x
M3 - Article
C2 - 17295759
AN - SCOPUS:33846939038
VL - 22
SP - 311
EP - 314
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
SN - 0815-9319
IS - 3
ER -