Colonoscopy in the elderly: a study of 200 cases.
OBJECTIVE
To evaluate tolerance and diagnostic yield of colonoscopy in elderly patients.


METHODS
We studied retrospectively 200 consecutive colonoscopies performed in patients older than 80 years (mean age: 83.5 +/- 3.1). We analyzed the following factors: indication, type and tolerance of the preparation, analgesia, tolerance of the procedure, information provided by the examination and therapeutic consequences.


RESULTS
The indications were: anaemia in 81 cases, change in bowel habits in 58 cases, rectal bleeding in 26 cases and others in 35 cases. Preparation (4.2 +/- 1.3 L Polyethylene-glycol) was good 150 times (75%), moderate 27 times and poor 23 times. It was tolerated well 122 times (61%) and poorly 78 times (39%). Sixty-six colonoscopies were performed without any analgesia, diazanalgesia was used in 108 cases, general anesthesia in 8 and diazepam and/or antispasmodics in 18. Tolerance of colonoscopy was good in 140 cases (70%), moderate in 37 cases and poor in 23 cases. Tolerance was better with analgesia than without (p < 0.001). The caecum was reached in 167 cases (83.5%). Colonoscopy was normal in 68 cases (34%). The lesions discovered were: 40 polyps larger than 10 mm, 41 diverticulosis, 29 cancers, 7 ischaemic colitis, 5 angiodysplasias, 5 sigmoiditis, 3 villous adenomas, 1 Bothriocephalus and 1 thermometric ulceration. A lesion responsible for the symptoms was diagnosed in 80 cases (40%). Diagnostic yield was better when indication was anaemia (52%) than change in bowel habits (24%) (p < 0.001). The lesions were treated endoscopically in 41 cases (38 polypectomies, 3 electrocoagulations) and surgically in 22 cases. Colonoscopy as well as its preparation were well tolerated in 93 cases (46.5%).


CONCLUSIONS
In a selected elderly population, colonoscopy was better tolerated with analgesia; large bowel preparation was often difficult. The diagnostic yield was relatively good. A multicentric prospective study is underway in order to determine the predictive criterias allowing an improvement of colonoscopic yield in the elderly.
Chatrenet
P
P
Centre Hospitalier, Blois, France.
Friocourt
P
P
Ramain
J P
JP
Cherrier
M
M
Maillard
J B
JB
D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012189:Retrospective Studies
D011092:Polyethylene Glycols