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Double-balloon enteroscopy in elderly patients: is it safe and useful?

Choi DH, Jeon SR, Kim JO, Kim HG, Lee TH, Lee WC, Kang BS, Cho JH, Jung Y, Kim WJ, Ko BM, Cho JY, Lee JS, Lee MS - Intest Res (2014)

Bottom Line: Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.

Methods: We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).

Results: In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).

Conclusions: DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

No MeSH data available.


Related in: MedlinePlus

Final diagnoses of study patients. In both groups, mucosal lesions were the most common finding, followed by tumorous lesions and vascular lesions. *Others represent Meckel's diverticulum and mucosal injury due to foreign body.
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Figure 1: Final diagnoses of study patients. In both groups, mucosal lesions were the most common finding, followed by tumorous lesions and vascular lesions. *Others represent Meckel's diverticulum and mucosal injury due to foreign body.

Mentions: Figure 1 shows the final diagnoses of the study participants. The most common final diagnosis in both groups was mucosal lesion. Mucosal lesions were identified in a significantly higher percentage of younger patients, more than double the percentage of patients in the elderly group. In both groups, tumorous lesion was the second most common final diagnosis, occurring at a significantly higher frequency in the elderly group. Diagnostic yield was slightly higher in the elderly group than in the younger group, but this difference was not significant (92.3% vs. 86.5%; P=0.422). The concordance rate between DBE and CE findings was 70% in the elderly group and 51.6% in the younger group; the difference in the rate was also not significant.


Double-balloon enteroscopy in elderly patients: is it safe and useful?

Choi DH, Jeon SR, Kim JO, Kim HG, Lee TH, Lee WC, Kang BS, Cho JH, Jung Y, Kim WJ, Ko BM, Cho JY, Lee JS, Lee MS - Intest Res (2014)

Final diagnoses of study patients. In both groups, mucosal lesions were the most common finding, followed by tumorous lesions and vascular lesions. *Others represent Meckel's diverticulum and mucosal injury due to foreign body.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214959&req=5

Figure 1: Final diagnoses of study patients. In both groups, mucosal lesions were the most common finding, followed by tumorous lesions and vascular lesions. *Others represent Meckel's diverticulum and mucosal injury due to foreign body.
Mentions: Figure 1 shows the final diagnoses of the study participants. The most common final diagnosis in both groups was mucosal lesion. Mucosal lesions were identified in a significantly higher percentage of younger patients, more than double the percentage of patients in the elderly group. In both groups, tumorous lesion was the second most common final diagnosis, occurring at a significantly higher frequency in the elderly group. Diagnostic yield was slightly higher in the elderly group than in the younger group, but this difference was not significant (92.3% vs. 86.5%; P=0.422). The concordance rate between DBE and CE findings was 70% in the elderly group and 51.6% in the younger group; the difference in the rate was also not significant.

Bottom Line: Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.

Methods: We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).

Results: In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).

Conclusions: DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

No MeSH data available.


Related in: MedlinePlus