Evaluation of endoscopic submucosal dissection in the treatment of early stage colorectal cancer and high-grade intraepithelial neoplasia in the elderly
HU Tingting1, ZHANG Jie2, JIN Yi3, WU Wenzhi1, SUN Xuecheng1, HONG Wandong1
1.Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.Department of Otolaryngology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 3.Department of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China
HU Tingting,ZHANG Jie,JIN Yi, et al. Evaluation of endoscopic submucosal dissection in the treatment of early stage colorectal cancer and high-grade intraepithelial neoplasia in the elderly[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(11): 911-916.
Abstract：Objective: To investigate the safety and efficacy of endoscopic submucosal dissection (ESD) in the treatment of early-stage colorectal cancer and high-grade intraepithelial neoplasia (HGIN) in the elderly. Methods: Clinical data of 157 patients with early-stage colorectal cancer and HGIN who received ESD treatment in the First Affiliated Hospital of Wenzhou Medical University from January 2021 to December 2021 were retrospectively analyzed. According to age, they were divided into the elderly group (≥60 years old, 91 cases) and the young group (18-59 years old, 66 cases). The baseline characteristics, lesion characteristics, success rate of operation, the time of operation and postoperative complications were compared between the two groups. Results: With only one patient who failed in the dissection and was transferred to surgery 156 patients received successful ESD. The maximum diameter of lesions was [2.5(1.7, 3.5)cm] in the elderly group and [2.0(1.5,2.6)cm] in the young group, showing statistical difference (P<0.05). The lesions in the elderly group were more likely to occur in the rectum, with significant difference (P<0.05). The incidence of postoperative complications in the elderly group was higher than that in the young group, and the difference was statistically significant(P<0.05). There was no significant difference between the two groups in the en bloc resection rate, complete resection rate and recurrence rate (P>0.05). Conclusion: ESD is a safe and effective therapy in the treatment of early-stage colorectal cancer and HGIN in elderly patients, who need more care for their larger lesions and higher postoperative complication rate, compared with the young patients.
