[Therapeutic methods of digestive tract endoscopy in older persons]

By the end of 1988 of 170 patients indicated for endoscopic papillotomy (EPT) 85 subjects were above 65 years of age and of these 54% were 75 years old or above that age. EPT was successful in 90.6% of subjects above 65 years of age. The total morbidity was 4.7% and the mortality 1.2%. Endoscopic colorectal polypectomy (EPE) was performed during the same period in 591 subjects. Of these 143 (24.2%) were above 65 years and in these subjects 284 polyps were removed. Almost half the polyps in these patients had a diameter of more than 10 mm, and adenomas of the right colon were at least three times more frequent than in asymptomatic subjects aged 45-60 years revealed by screening of colorectal neoplasms in HaemocultR-positive subjects. Special attention was devoted to patients with malignant polyps and with very broadly attached adenomas of the left colon. Almost three quarters of patients with very broadly attached adenomas could be definitely treated by the endoscopic method. EPT is in many instances the only possible therapeutic approach in old and risk patients. Every colorectal polyp should be evaluated by endoscopy and EPE is in particular in subjects of advanced age the method of choice, when technically feasible.