Endoscopic mucosal resection in elderly patients

Area of Science:

• Gastroenterology
• Oncology
• Surgical Endoscopy

Background:

• Endoscopic mucosal resection (EMR) is the standard treatment for early superficial colorectal carcinomas.
• Evaluating EMR in elderly patients is crucial due to potential comorbidities and altered physiological responses.
• Submucosal infiltration is a key factor influencing treatment outcomes in colorectal neoplasia.

Purpose of the Study:

• To assess the efficacy and safety of endoscopic mucosal resection (EMR) in elderly patients with early colorectal cancer.
• To determine the predictive value of submucosal infiltration on EMR outcomes in this demographic.
• To provide evidence supporting the use of EMR as a primary treatment modality for selected elderly patients.

Main Methods:

• Retrospective analysis of 50 patients undergoing EMR for Paris classification IIa colorectal polyps (April 2013-April 2015).
• Patients were stratified into two groups based on a 65-year age cutoff to define elderly status.
• Data collected included lesion characteristics, resection technique (en bloc vs. piecemeal), and complete resection rates.

Main Results:

• EMR was performed on 53 lesions, with 79.2% achieving complete resection.
• Lesion locations varied across the colon, with the rectum being the most common site (30%).
• Ten patients required surgery due to incomplete resection or histological findings, indicating the importance of careful patient selection and follow-up.

Conclusions:

• Colonoscopic Endoscopic Mucosal Resection (EMR) is a safe and effective procedure for elderly patients with early superficial colorectal neoplasms.
• EMR aids in appropriate surgical indication selection, particularly for elderly patients with high surgical risks.
• The findings support the continued use of EMR as a valuable tool in managing colorectal cancer in the aging population.