Endoscopic submucosal dissection is useful and safe for intramucosal gastric neoplasms in the elderly

Background and study aims : Endoscopic submucosal dissection (ESD) has recently gained popularity for use against intramucosal gastric neoplasms in Japan, but few studies have examined whether ESD is feasible for elderly patients. This study aims are to evaluate the efficacy and safety of ESD according to age in con- secutive elderly patients treated with ESD. Patients and methods : Subjects comprised 116 patients (90 men, 26 women) with 125 lesions treated using ESD from November 2002 to March 2006 at Nagoya City University Hospital and Iwata Municipal Hospital, Japan. Patients were categorized into : Group A, < 65-years-old (n = 34) ; Group B, ?? 65-years-old but < 75- years-old (n = 41) ; and Group C, ?? 75-years-old (n = 41). En bloc resection rate and treatment time were examined according to age, tumour size and location, and frequency of complications was examined according to age. Results : Rate of concomitant disease was significantly higher in Group C than in the other groups. En bloc resection rates and median treatment times were 91.4% and 80 min in Group A, 91.1% and 97 min in Group B and 86.7% and 110 min in Group C, respectively. No significant differences were noted between groups, or for en bloc resection rate and treatment time according to tumour size and location, or between groups for frequency of complications. Conclusions : ESD for gastric neoplasms is effective and safe in elderly patients, and may be positively recommended to elderly patients with intramucosal gastric neoplasms. (Acta gastroenterol. belg., 2007, 70, 323-330).Background and study aims : Endoscopic submucosal dissection (ESD) has recently gained popularity for use against intramucosal gastric neoplasms in Japan, but few studies have examined whether ESD is feasible for elderly patients. This study aims are to evaluate the efficacy and safety of ESD according to age in con- secutive elderly patients treated with ESD. Patients and methods : Subjects comprised 116 patients (90 men, 26 women) with 125 lesions treated using ESD from November 2002 to March 2006 at Nagoya City University Hospital and Iwata Municipal Hospital, Japan. Patients were categorized into : Group A, < 65-years-old (n = 34) ; Group B, ?? 65-years-old but < 75- years-old (n = 41) ; and Group C, ?? 75-years-old (n = 41). En bloc resection rate and treatment time were examined according to age, tumour size and location, and frequency of complications was examined according to age. Results : Rate of concomitant disease was significantly higher in Group C than in the other groups. En bloc resection rates and median treatment times were 91.4% and 80 min in Group A, 91.1% and 97 min in Group B and 86.7% and 110 min in Group C, respectively. No significant differences were noted between groups, or for en bloc resection rate and treatment time according to tumour size and location, or between groups for frequency of complications. Conclusions : ESD for gastric neoplasms is effective and safe in elderly patients, and may be positively recommended to elderly patients with intramucosal gastric neoplasms. (Acta gastroenterol. belg., 2007, 70, 323-330).