The efficacy and safety of colonoscopy in nonagenarians: A multicenter study
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ORIGINAL ARTICLE
The efficacy and safety of colonoscopy in nonagenarians: A multicenter study Yoshikazu Inagaki 1 & Naohisa Yoshida 2 & Daisuke Hasegawa 3 & Kyoichi Kassai 1 & Ritsu Yasuda 2 & Ken Inoue 2 & Ryohei Hirose 2 & Osamu Dohi 2 & Takashi Okuda 4 & Yutaka Inada 4 & Kotaro Okuda 5 & Kiyoshi Ogiso 6 & Akira Tomie 7 & Koichi Soga 8 & Takaaki Murakami 9 & Yoshito Itoh 2 Received: 26 March 2020 / Accepted: 15 June 2020 # Indian Society of Gastroenterology 2020
Abstract Introduction The number of colonoscopy (CS) for the elderly is increasing. There are only a few reports focusing on CS among the very elderly aged ≥ 90-y. We aimed to analyze the efficacy of CS and of colorectal cancer (CRC) for patients aged ≥ 90-y. Methods We retrospectively analyzed consecutive patients aged ≥ 90-y receiving CS at eight institutions from October 2016 to September 2017. Bowel preparation, complications, and endoscopic diagnosis were analyzed. The non-elderly group aged between 50-y and 64-y and elderly group aged between 65-y and 79-y were compared to very-elderly group aged ≥ 90-y. Through propensity score matching of sex and CS indications (symptomatic or asymptomatic), the number of CRC and the treatment in each group were analyzed. Results We analyzed 125 patients receiving 154 colonoscopies (0.9%) in the very-elderly group from among 16,968 cases. Among 92 cases who received bowel-cleansing solution, good preparations were achieved in 94.5%. The rate of CSrelated complications was 1.3% (2/154). The rate of CRC in the very-elderly group was 27.2% (34/125), higher than the non-elderly group (7.2%, 9/125, p < 0.01) and elderly group (8.8%, 11/125, p < 0.01). Therapeutic interventions for CRC in the very-elderly group were performed in 73.5% (24/34) patients. The mean survival of 12 patients with CRC resection was 788 days. Conclusions CS could be performed safely for the very elderly aged ≥ 90-y with careful considerations. CRC was confirmed to be more frequent in this group with over 70% of patients receiving appropriate therapeutic intervention. Keywords Bowel preparation . Cecal intubation . Colonic polyp . Colonoscopy . Colonoscopy complication . Colorectal cancer . Comorbidity . Elderly . Polypectomy . Screening colonoscopy . Surveillance
* Naohisa Yoshida [email protected] 1
Department of Gastroenterology, Nishijin Hospital, Kyoto, Japan
2
Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
3
Department of Gastroenterology, Ayabe City Hospital, Kyoto, Japan
4
Department of Gastroenterology, Fukuchiyama City Hospital, Kyoto, Japan
5
Department of Gastroenterology, Kyoto Kujyo Hospital, Kyoto, Japan
6
Department of Gastroenterology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
7
Department of Gastroenterology, Saiseikai Kyoto Hospital, Kyoto, Japan
8
Department of Gastroenterology, Omihachiman Community Medical Center, Omihachiman, Shiga, Japan
9
Department
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