title: Colonic endoscopic mucosal resection of large polyps: Is it safe in the very elderly?
abstract: BACKGROUND
  Outcomes on colon endoscopic mucosal resection in the very elderly patient population are unknown.
  
  
  OBJECTIVE
  Aims of this study were to evaluate the outcomes and safety of colon endoscopic mucosal resection in this target population.
  
  
  METHODS
  Observational, retrospective study of patients ≥ 80 years of age that underwent colon endoscopic mucosal resection ≥ 2 cm. Demographics, American Society of Anesthesiologists classification, procedural data, and surgical treatment data were collected.
  
  
  RESULTS
  One-hundred-and-thirty-one colon endoscopic mucosal resections were performed on 99 patients ≥ 80 years of age with a mean age of 84. The majority of American Society of Anesthesiologists class was II. Mean lesion size was 3.3 cm (range, 2-12.5 cm), more procedures were performed in the right colon and adenoma/tubulovillous adenoma was the most common pathology. En bloc resection was performed on 26.7% of polyps (N=35). Eight procedure-related adverse events (8/131, 6.1%) occurred. No anaesthesia related adverse events or deaths occurred. Six patients required a colonic operation, and overall, 94% of the patient cohort evaded a colon operation.
  
  
  CONCLUSIONS
  Colon endoscopic mucosal resection in very elderly patients can be performed at experienced endoscopy centres with a low rate of complications and offers these patients a non-surgical option of management of colorectal lesions.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States. Electronic address: gomez.victoria@mayo.edu.
authors.forename: Victoria
authors.initials: V
authors.lastname: Gómez
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, United States.
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Racho
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Woodward
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wallace
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
authors.forename: Massimo
authors.initials: M
authors.lastname: Raimondo
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
authors.forename: Ernest P
authors.initials: EP
authors.lastname: Bouras
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Lukens
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D047368:Tumor Burden
keywords: Colorectal lesions; Complication rates; Endoscopic mucosal resection; Octogenarian patient; Polypectomy