Endoscopic mucosal resection in elderly patients
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Endoscopic mucosal resection (EMR) of early superficial colorectal carcinomas is nowadays accepted as the gold standard treatment for this type of neoplasia.
This study aims to evaluate the efficacy and safety of mucosectomy in elderly patients considering the predictive value of submucosal infiltration.
A retrospective study of all patients referred for EMR of sessile colorectal polyps classified IIa by the Paris classification between April 2013 and April 2015. A total of 50 patients (30 males (60 %); age range = 44–86; mean age = 67.7) were enrolled. Patients were divided in two groups considering 65 years as cutoff to individuate the elderly patients.
EMR was performed in 53 lesions: 39 were performed en bloc and 14 by piecemeal technique. 30 % of lesions were in the rectum; 11 % in the sigmoid colon; 15 % in the descending colon; 6 % in the transverse colon; 24 % in the ascendant colon; and 14 % in the cecum. The mean size of the resected specimens was 20 mm (range 8–80 mm). The rate of complete resection was 79.2 %, incomplete 13.2 %, not estimable 7 %. Ten patients underwent surgery because of an incomplete resection and/or histological evaluation.
Colon EMR is safe and effective in elderly patients. Endoscopy is still helped in the correct indication for surgery in high-risk surgical patients.
KeywordsElderly patients Lifting sign Endoscopic resection Submucosal invasion Polyp Colonoscopy Colorectal cancer
Endoscopic submucosal resection
Argon plasma coagulator
Compliance with ethical standards
Conflict of interest
All authors listed have contributed sufficiently to the project to be included as authors, and to the best of our knowledge, no conflict of interest, financial or other exists.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
The authors declare that they have received no funding for the study.
Informed consent to the endoscopic procedure and to the processing of own personal data was obtained from each individual study participant. In accordance with Italian Drug Agency (AIFA) guidelines, observational studies using retrospective data or materials do not require formal approval by the local ethics committee. Informed consent was obtained from all individual participants included in the study.
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