Therapeutic methods of digestive endoscopy in persons of advanced age.

Abstract

Towards the end of 1988, 85 out of 170 patients indicated for endoscopic papillotomy (EPT) were over 65 years of age, and, of these, 54% were 75 and more. EPT was successful in 90.6% of those over 65. Total morbidity was 4.7% and mortality 1.2%. Endoscopic colorectal polypectomy (EPE) was performed during the same period in 591 subjects. 143 of them (24.2%) were over 65 and had a total of 284 polyps removed. Almost half those polyps were more than 10 mm in diameter. Adenomas of the right colon were at least 3 times as frequent as in asymptomatic subjects aged 45-60 years revealed by screening for colorectal neoplasms in HaemocultR-positive subjects. Particular attention was devoted to patients with malignant polyps and with very broadly sessile adenomas--both could definitively be treated with the endoscopic method. EPT is often the only possible therapy for elderly and high-risk patients. Every colorectal polyp should be evaluated by endoscopy, and EPE, especially in patients of advanced age, is the method of choice when technically feasible.