title: Treatment of elderly patients with early gastric cancer by endoscopic submucosal dissection using an insulated-tip diathermic knife.
abstract: OBJECTIVE
  In recent years, the number of elderly patients with early gastric cancer (EGC) has steadily been increasing. In our institute, endoscopic submucosal dissection (ESD) involving the use of an insulated-tip diathermic knife (IT-ESD) was introduced for the treatment of mucosal gastric carcinoma in 1996. The purpose of this study was to evaluate the effectiveness of IT-ESD for the treatment of elderly patients with EGC.
  
  
  METHODS
  A total of 144 patients with EGC were treated at Shikoku Cancer Center in the 5-year period from January 2000 to December 2004, including 53 patients over 75 years old. The performance status (PS) for all patients was less than 2. We compared patient's backgrounds, the one-piece resection rate, complete resection (CR) rate, operation time, bleeding rate, perforation rate, blood pressure, and peripheral oxygen saturation (SpO(2)) between patients over 75 years of age (elderly group) and the remaining 91 younger patients (non-elderly group).
  
  
  RESULTS
  The rate of having underlying disease was significantly higher for the elderly group (p<0.05) and we found no significant difference for the one-piece resection rate, CR rate, operation time, bleeding rate, and perforation rate between the 2 groups. There were also no significant differences for the frequency of the use of oxygen, pressor and depressor between the 2 groups.
  
  
  CONCLUSIONS
  There was no significant difference in the outcome resulting from ESD between the 2 groups. Our study proves that ESD is a feasible treatment for elderly patients with EGC PS of less than 2.
authors.affiliation: Department of Endoscopy, Shikoku Cancer Center, Matsuyama.
authors.forename: Shoji
authors.initials: S
authors.lastname: Hirasaki
authors.forename: Masahito
authors.initials: M
authors.lastname: Tanimizu
authors.forename: Junichirou
authors.initials: J
authors.lastname: Nasu
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Shinji
authors.forename: Norio
authors.initials: N
authors.lastname: Koide
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D004564:Electrocoagulation / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005753:Gastric Mucosa; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*