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DOI: 10.1055/s-0038-1637579
CLINICAL SIGNIFICANCE AND SAFETY OF COLONOSCOPY IN ELDERLY PATIENTS
Publication History
Publication Date:
27 March 2018 (online)
Aims:
Current guidelines do not suggest an upper age cutoff for colorectal cacner (CRC) screening with colonoscopy (CFS). The aims of this study were to assess the clinical significance and safety of CFS, and to analyze predictive factor of CRC in elderly patients.
Methods:
From January 2008 to December 2012, clinical data of 479 patients older than 75 years who underwent CFS was reviewed retrospectively. Emergent cases of gastrointestinal bleeding, previous history of CRC or inflammatory bowel disease and cases with the history of CFS experience within 5 years were excluded.
Results:
Mean age was 77.96 years and male to female ratio 1:0.53. One hundred forty four patients (30.06%) were asymptomatic individuals undergoing screening or surveillance CFS, whereas 335 patients (69.94%) had specific symptoms prior to CFS, most commonly abdominal pain or discomfort (20.04%). Complication was noted in 4 patients (0.84%), in which all cases were immediate bleeding that was successfully controlled by endoscopic clipping and epinephrine injection. The overall frequency of advanced adenoma and CRC was 10.02% (n = 48) and 23.17% (n = 111), respectively. Most common location of CRC was rectosigmoid area (56.76%), and 66.66% of the patients underwent colectomy. In patients with CRC, most common indication of CFS was blood in stool (27.9%), while in rest of patients without CRC was for screening or surveillance purpose (34.0%), followed by abdominal pain or discomfort (20.9%).
Conclusions:
Our study showed that complete CFS could be performed safely and the possibility of CRC was high in cases with bloody stool or anal bleeding in patients older than 75 years. Therefore, we should consider performing CFS in such patients. Taking into account that most of the CRC in elderly was found in rectosigmoid area, sigmoidoscopy can also be a safe alternative if patient's risk of complication associated with CFS is considered high.