Endoscopic submucosal dissection is useful and safe for intramucosal gastric neoplasms in the elderly.
OBJECTIVE
Endoscopic submucosal dissection (ESD) has recently gained popularity for use against intramucosal gastric neoplasms in Japan, but few studies have examined whether ESD is feasible for elderly patients. This study aims are to evaluate the efficacy and safety of ESD according to age in consecutive elderly patients treated with ESD.


METHODS
Subjects comprised 116 patients (90 men, 26 women) with 125 lesions treated using ESD from November 2002 to March 2006 at Nagoya City University Hospital and Iwata Municipal Hospital, Japan. Patients were categorized into: Group A, <65-years-old (n=34); Group B, > or =65-years-old but <75-years-old (n=41); and Group C, > or = 75-years-old (n=41). En bloc resection rate and treatment time were examined according to age, tumour size and location, and frequency of complications was examined according to age.


RESULTS
Rate of concomitant disease was significantly higher in Group C than in the other groups. En bloc resection rates and median treatment times were 91.4% and 80 min in Group A, 91.1% and 97 min in Group B and 86.7% and 110 min in Group C, respectively. No significant differences were noted between groups, or for en bloc resection rate and treatment time according to tumour size and location, or between groups for frequency of complications.


CONCLUSIONS
ESD for gastric neoplasms is effective and safe in elderly patients, and may be positively recommended to elderly patients with intramucosal gastric neoplasms.
Shimura
T
T
Nagoya City University, Graduate School of Medical Sciences, Department of Gastroenterology and Metabolism, 1 Kawasumi, Mizuho, Nagoya 467-8601, Japan. tshimura@med.nagoya-cu.ac.jp
Joh
T
T
Sasaki
M
M
Kataoka
H
H
Tanida
S
S
Ogasawara
N
N
Yamada
T
T
Kubota
E
E
Wada
T
T
Inukai
M
M
Yoshioka
N
N
Saida
Y
Y
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016063:Blood Loss, Surgical; D004210:Dissection / Q000379:methods*; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D013270:Stomach / Q000293:injuries; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome