Safety and Usefulness of Colonfibroscopy in the Very Elderly

Abstract

The population of elderly people has increased in recent years. The importance of endoscopy as a diagnostic tool is indisputable. The feasibility and safety of upper gastrointestinal tract panendoscopy and sigmoidoscopy in elderly patients has been reported previously. However, there are still no reports about colonfibroscopy in the elderly, especially for the very elder patients (aged 80 years or above). This retrospective study reviewed the chart and endoscopic records of patients aged 80 or more who underwent colonfibroscopy examination at our hospital from January 1992 to December 1997. The basic clinical information, indications of endoscopy, the diagnostic results, and the followup conditions were all recorded and analyzed. A total of 240 colonfibroscopy examinations were performed in 189 patients. All the patients tolerated the procedure well. No complications were noted during and after the colonfibroscopy studies. The most frequent indication of colonfibroscopy was bloody stool and/or positive stool occult blood test. In considering the final diagnosis, adenoma and/or polyp, hemorrhoids, and colorectal cancer were the three most frequent etiologies in these patients. Only 17 examinations could not be properly completed due to poor colon preparation. Colonfibroscopy was a safe and useful diagnostic tool for the very elder patients. These very elderly patients had a high incidence of colorectal cancer, especially for those who had a past history of colorectal cancer (metachronous cancer). Those who had bloody stool and/or positive stool occult blood test, bowel habit change or anemia, and who have a history of colorectal cancer should undergo the colonfibroscopy.