Article

Surgical Endoscopy

, Volume 21, Issue 10, pp 1806-1809

First online:

Colonoscopy in the very elderly: a review of 157 cases

  • Marc ZereyAffiliated withDivision of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center
  • , B. Lauren PatonAffiliated withDivision of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center
  • , Philip D. KhanAffiliated withDivision of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center
  • , Amy E. LincourtAffiliated withDivision of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center
  • , Kent W. KercherAffiliated withDivision of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center
  • , Frederick L. GreeneAffiliated withDivision of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center
  • , B. Todd HenifordAffiliated withDivision of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Background

Colonoscopy is currently the best diagnostic modality for evaluating colonic diseases but studies of its use in the very elderly are limited.

Methods

A single-institution review of all patients aged 85 years or older who underwent colonoscopy from June 2003 to June 2005 was performed. Parameters evaluated included indications for colonoscopy, findings, ability to perform a complete colonoscopy, and immediate and delayed (≤21 days) complications.

Results

A total of 157 patients aged 85 years or older (median = 87, range = 85–99) underwent colonoscopy during the two-year period. The cecal intubation rate was 90%. Number of cancers detected/indications for colonoscopy include gross or occult bleeding per rectum, 3/51 (5.9%); abnormal physical exam, 1/2 (50%); abnormal abdominal computed tomography, 3/5 (60%); anemia, 1/25 (4.0%); screening, 0/14; previous history of colonic malignancy, 0/10; previous history of polyps, 0/21; change in bowel habits, 0/5; family history of colonic malignancy, 0/6; abdominal pain, 0/4; diarrhea, 0/6; fecal impaction, 0/2; unknown, 0/6. Immediate complications included hemorrhage at a polypectomy site in one patient that was controlled endoscopically, one episode of bradycardia, and one incident of atrial fibrillation. There were no delayed complications resulting from colonoscopy.

Conclusions

Our data suggest that colonoscopy can be safely and successfully performed in the very elderly. In patients with symptoms or suggestive radiographic findings, cancer was detected in 4.0%–60% of cases. No cases of cancer were discovered in those patients who were asymptomatic.

Keywords

Colorectal cancer Colonoscopy Elderly