Outcomes of Colonic Endoscopic Mucosal Resection for Large Polyps in Elderly Patients

The aim of this study is to investigate the short-term outcomes of endoscopic mucosal resection (EMR) for large colonic polyps in elderly patients (≥80 years) compared with those in younger patients (<80 years).

A total of 339 patients who underwent colon EMR ≥2 cm were included. Sixty-five colon EMRs were performed on 46 patients ≥80 years (Group A) and 401 resections were performed on 293 patients <80 years. Demographics, operative and short-term results were compared between the two groups.

The median age in Group A was 83.5 years (range 80-91 years) and 66 years in Group B (range 26-79 years, P < .001). The proportion of patients with American Society of Anesthesiologists class III was significantly high in Group A (39.1% versus 17.7%, P = .001). There was no significant difference in sex ratio, body mass index, tumor size, and tumor distribution between the two groups. Median operating time was similar between the two groups (30 versus 30 minutes, P = .839). En bloc resection rate was 33.8% in Group A and 29.2% in Group B (P = .445). No anesthesia-associated adverse events or deaths occurred in both groups. Complication rate was similar between the two groups, perforation rate was 2.2% in Group A and 1.7% in Group B (P = .823), and delayed bleeding rate was 4.3% versus 3.1% (P = .650), respectively.

Colon EMR is feasible and safe in very elderly patients.