Colonoscopy over 80 years – experiences in our department

Introduction: Colonoscopy is considered as an easy and safe endoscopic procedure that can give the most accurate diagnosis in most cases of suspected diseases of the large bowel, and also has a potential to perform even therapeutic interventions. Our aim was to assess the diagnostic and therapeutic specifications of colonoscopies in patients over 80 years. Patients and methods: we retrospectively analysed our colonoscopy practice: During a 6-month period we performed 1361 colonoscopies in our department. 155 (11.4%) of the pts was older than 80 years. The main indications were GI bleeding, suspected malignancy and diagnostic workup for anemy. Results: The majority of pts (81.3%) got their examination not on ambulantory basis due to significant number of severe comorbidities in this age group. Inappropriate bowel cleansing was more frequent in older pts (33.6%) than in younger ones (25.8%). The negative result was less frequent in older ages. We used much more less frequently conscious sedation in older pts (14.2%). The rate of complete colonoscopy was suprisingly low, only 62.6%. It can be explained by high pencentage of incomplete bowel cleansing and a high number of tumors occluding the lumen. Complication rate due to bowel cleansing, diagnostic procedures and therapeutic interventions is higher (2.6%) among olders.

Conclusion: To perform colonoscopy safely in older pts needs more efforts from us, than in case of youngers. A longer duration of bowel cleansing – in hospital, if possible-, a cautious sedation and monitoring older patients during colonoscopy and postprocedurally are the key issues that should follow in this subgroup of patients.