Perioperative complications of endoscopic submucosal dissection for early gastric cancer in elderly Japanese patients 75 years of age or older.
OBJECTIVE
The number of endoscopic submucosal dissection (ESD) procedures for early gastric cancers among patients 75 years of age or older has been increasing. We herein examined both the outcomes and complications of ESD in elderly patients.


METHODS
We investigated the effects of underlying diseases, lesion characteristics, treatment outcomes and complications during and in the postoperative periods of ESD among elderly patients 75 years of age or older versus non-elderly patients less than 75 years of age. Patients A total of 318 early gastric cancers in consecutive 307 patients, all of whom underwent ESD for gastric cancer, were included in this study.


RESULTS
The number of patients with hypertension and ischemic heart disease was significantly higher in the elderly group than in the non-elderly group. The proportion of lesions with an absolute indication, extended indication or no indication was not significantly different between the groups. During the ESD procedure, the use of atropine sulfate for bradycardia was significantly more frequent in the elderly group. No significant differences were observed between the groups in terms of the treatment for hypertension, oxygen administration or incidence of perforation. In addition, there were no significant differences with respect to oxygen administration, postoperative bleeding or the occurrence of fever and/or pneumonia after the ESD procedure.


CONCLUSIONS
Although bradycardia was more frequently observed in the elderly patients during ESD in this study, ESD was performed safely and managed appropriately, with infrequent postoperative complications. ESD appears to be effective, even in elderly patients.
Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Japan.
Daisuke
D
Chinda
Yoshio
Y
Sasaki
Tetsuya
T
Tatsuta
Kiyoto
K
Tsushima
Toyohito
T
Wada
Tadashi
T
Shimoyama
Shinsaku
S
Fukuda
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D015897:Comorbidity; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D018572:Disease-Free Survival; D004210:Dissection / Q000009:adverse effects; D055088:Early Detection of Cancer; D005240:Feasibility Studies; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy / Q000009:adverse effects*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome