| 特集名 | 超高齢化社会に向けた大腸内視鏡検査 | |
|---|---|---|
| 題名 | 超高齢者大腸内視鏡検査の工夫 (1) 大学病院：当院における超高齢者に対する大腸内視鏡検査・治療 | |
| 発刊年月 | 2015年 01月 | |
| 著者 | 山内 章裕 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 工藤 進英 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 宮地 英行 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 宍戸 華子 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 片桐 敦 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 工藤 豊樹 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 三澤 将史 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 石田 文生 | 昭和大学横浜市北部病院消化器センター |
| 【 要旨 】 | 当施設において，大腸内視鏡検査を受けた80歳以上の患者の割合は2002年で4.6％だったが，2013年には9.3％と約2倍に増加した．高齢者の大腸内視鏡検査前処置では全年齢層と比較して穿孔や腸閉塞などの前処置関連偶発症が多くはなかった．前投薬・挿入時の合併症に関して，大きな合併症は認めていない．内視鏡治療に伴う後出血も高齢者のほうが起きやすい傾向は認めなかった．ただしEMRに関しては，高齢者のほうが後出血しやすい傾向だった． | |
| Theme | Colonoscopy for the super-elderly | |
|---|---|---|
| Title | Safety of colonoscopy in elderly patients | |
| Author | Akihiro Yamauchi | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Shin-ei Kudo | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Hideyuki Miyachi | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Hanako Shishido | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Atsushi Katagiri | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Toyoki Kudo | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Masashi Misawa | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Fumio Ishida | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] | In our hospital, the number of patients over 80 years of age undergo endoscopy has increased from 4.6 % of all patients in 2002 to 9.3 % in 2013. In terms of complications in elderly patients, the number of cases with complications such as preparation related perforations and ileus were not significantly different from other age groups. The incidence rate of complications related to endoscopic treatment was almost the same for elderly patients and those under 65 years of age. Colonoscopy was introduced to reduce mortality rates due to colorectal cancer. Initially it was considered to be sufficiently applicable and useful for treating elderly patients. However, older patients are likely to have underlying diseases or impaired cardiovascular or respiratory functions. Those factors may be the cause of fatal complications in some cases. We need to consider the advantages as well as the risks associated with endoscopic therapy. We must carefully consider the general condition of individual elderly patients. We must provide informed consent and examine the application of colonoscopy. |
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