COLONOSCOPY IN PATIENTS AGED 80 YEARS OR OLDER AND ITS CONTRIBUTION TO THE EVALUATION OF RECTAL BLEEDING
COLONOSCOPY IN PATIENTS AGED 80 YEARS OR OLDER AND ITS CONTRIBUTION TO THE EVALUATION OF RECTAL BLEEDING
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DOI：
10.1136/pgmj.68.799.355
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发表时间：
1992-05-01
影响因子：
5.1
通讯作者：
ROSENBLUM, Y
中科院分区：
文献类型：
--
作者：
BAT, L;PINES, A;ROSENBLUM, Y
根据手术的主要适应症分析了在Sheba医疗中心对80岁或以上患者进行的结肠镜检查：101例结肠镜检查是因为直肠出血至少持续2个月，335例是因为所有其他适应症。29例（28.7%）出血患者中发现大肠癌，直肠是最常见的受累部位（12例患者）。在非出血者中，癌症的患病率明显较低（33例，9.8%; P < 0.001），直肠癌较不常见（5例，P = 0.04），但近端肿瘤更常见。在接受手术的癌症患者中，大多数（72%）肿瘤局限于肠壁（Dukes A或B）。两组的腺瘤发生率相似（34% vs 29%）。与出血者相比，非出血者更常抱怨腹痛或排便习惯改变，但两组贫血和体重减轻的发生率相似。总的来说，47%的癌症患者和26%的腺瘤患者因直肠出血而接受结肠镜检查。该手术在老年人中是安全的，因为我们在我们的系列中仅记录了4例（0.9%）非致命性并发症，与我们研究所的并发症总发生率相似。总之，我们的数据表明，直肠出血的老年人需要一个完整的结肠调查，最好是全结肠镜检查。
Colonoscopies performed in patients aged 80 years or older at the Sheba Medical Center were analysed according to the primary indication for the procedure: 101 colonoscopies were performed because of rectal bleeding of at least 2 months duration, and 335 for all other indications. Carcinoma of the large bowel was found in 29 (28.7%) bleeders, with the rectum being the most frequently involved site (12 patients). Among the non-bleeders, the prevalence of cancer was significantly lower (33 cases, 9.8%; P < 0.001), and rectal carcinoma was less common (five patients, P = 0.04), but proximal tumours were more frequent. Of patients with cancer who had operations, the majority (72%) had a tumour confined to the bowel wall (Dukes A or B). The rate of adenomas was similar for both groups (34% vs 29%). The non-bleeders complained more frequently of abdominal pain or a change in bowel habits as compared to the bleeders, but both groups had similar rates for anaemia and weight loss.In all, 47% of these octogenarians with cancer, and 26% with adenomas were referred for colonoscopy because of rectal bleeding. This procedure was found to be safe in old age, as we recorded only four (0.9%) non-fatal complications among our series, a similar figure to the overall incidence of complications at our Institute. In conclusion, our data indicate that rectal bleeding in octogenarians warrants a complete colonic investigation, preferably by total colonscopy.