Endoscopic submucosal dissection for treatment of laterally spreading tumors in elderly patients
Objective:To analyze the endoscopic manifestations and clinical characteristics of laterally spreading tumors (LSTs) in elderly patients, and to assess the feasibility and safety of endoscopic submucosal dissection (ESD) in the treatment of these patients.Methods:A retrospective analysis was performed on the clinical data of 79 cases of LSTs who that were treated by ESD at our hospital from January 2021 to October 2022. These included 55 cases of elderly patients (≥60 years) and 24 cases of non-elderly patients (<60 years). The patients’ sex and age, tumor morphology, tumor location, tumor pathology, overall resection rate, complete resection rate, adverse reactions, and follow-up results were recorded.Results:The average age of the elderly group was (67.54±5.83) years old, and that of the non-elderly group was (52.95±7.68) years old. There was no significant difference in gender or age between the two groups (P>0.05). The tumor morphology in the two groups was mainly LST-G-H (homogeneous type), the tumor location in the two groups was mainly the ascending colon, and the pathological type in the two groups was mainly tubular adenoma. There was no significant difference in tumor shape, location, or pathological type between the two groups (P>0.05). There was 1 case of postoperative perforation (1.82%) and 2 cases of postoperative infection (3.64%) in the elderly group, while there was 1 case of postoperative hemorrhage (4.17%) and 1 case of postoperative perforation (4.17%) in the non-elderly group; there was no significant difference in the incidence of complications between the two groups (P>0.05). There were 7 cases (12.73%) of positive incisal margin in the elderly group, and 3 cases (12.5%) in the non-elderly group; there was no significant difference in the rate of complete resection between the two groups (P>0.05). During the follow-up period of 6 months, there was were no residual or recurrent lesions in either group.Conclusion:The morphology, location, and pathology of LSTs of the large intestine in elderly patients are similar to those in young patients. ESD is safe and effective in the treatment of LSTs of the large intestine.
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