TY - JOUR
T1 - The safety and efficacy of single balloon enteroscopy in the elderly
AU - Davis-Yadley, Ashley H.
AU - Lipka, Seth
AU - Rodriguez, Andrea C.
AU - Nelson, Kirbylee K.
AU - Doraiswamy, Vignesh
AU - Rabbanifard, Roshanak
AU - Kumar, Ambuj
AU - Brady, Patrick G.
N1 - Publisher Copyright:
© SAGE Publications.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background: Single balloon enteroscopy (SBE) is an important tool in the management of small bowel disease with limited data available on its performance in the elderly. We aimed to evaluate the safety, efficacy, diagnostic and therapeutic outcomes of SBE in the elderly. Methods: A retrospective review was performed on 366 patients undergoing 428 SBEs from 2010 to 2014. Patients were divided into different age groups: control <55, 55-64, 65-74 and ≥75 years. Data on comorbidities, complications, findings, diagnostic and therapeutic yield were compared between groups. Results: Anterograde and retrograde SBE were performed in 340 and 49 patients, respectively, with 63 patients requiring more than 1 procedure. Diagnostic yield was significantly higher for age ≥75 years compared with <55, 66.3% versus 50%, odds ratio (OR) 1.97 [95% confidence interval (CI) 1.14-3.41]. Therapeutic yield was significantly higher in all three older age groups compared with <55 years, 20.3%: 55-64 years, 44.4%, OR 3.13(95% CI 1.7-5.78); 65-74 years, 42%, OR 2.84 (95% CI 1.59-5.06); and >75 years, 47.5%, OR 3.55 (95% CI 1.96-6.43). No significant difference was seen between age groups in complications or failures. Our overall complication rate was 2.3% with 5 minor and 5 major complications. There was a higher yield of angioectasias in the elderly. Argon plasma coagulation (APC) and multipolar electrocoagulation were used more often in older age groups. Conclusion: SBE is safe in elderly patients and delivers higher diagnostic and therapeutic yields compared to younger patients. The elderly are more likely to have angioectasias and undergo APC and electrocoagulation.
AB - Background: Single balloon enteroscopy (SBE) is an important tool in the management of small bowel disease with limited data available on its performance in the elderly. We aimed to evaluate the safety, efficacy, diagnostic and therapeutic outcomes of SBE in the elderly. Methods: A retrospective review was performed on 366 patients undergoing 428 SBEs from 2010 to 2014. Patients were divided into different age groups: control <55, 55-64, 65-74 and ≥75 years. Data on comorbidities, complications, findings, diagnostic and therapeutic yield were compared between groups. Results: Anterograde and retrograde SBE were performed in 340 and 49 patients, respectively, with 63 patients requiring more than 1 procedure. Diagnostic yield was significantly higher for age ≥75 years compared with <55, 66.3% versus 50%, odds ratio (OR) 1.97 [95% confidence interval (CI) 1.14-3.41]. Therapeutic yield was significantly higher in all three older age groups compared with <55 years, 20.3%: 55-64 years, 44.4%, OR 3.13(95% CI 1.7-5.78); 65-74 years, 42%, OR 2.84 (95% CI 1.59-5.06); and >75 years, 47.5%, OR 3.55 (95% CI 1.96-6.43). No significant difference was seen between age groups in complications or failures. Our overall complication rate was 2.3% with 5 minor and 5 major complications. There was a higher yield of angioectasias in the elderly. Argon plasma coagulation (APC) and multipolar electrocoagulation were used more often in older age groups. Conclusion: SBE is safe in elderly patients and delivers higher diagnostic and therapeutic yields compared to younger patients. The elderly are more likely to have angioectasias and undergo APC and electrocoagulation.
KW - efficacy
KW - elderly
KW - safety
KW - single balloon enteroscopy
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U2 - 10.1177/1756283X15614517
DO - 10.1177/1756283X15614517
M3 - Article
C2 - 26929779
AN - SCOPUS:84957886418
SN - 1756-283X
VL - 9
SP - 169
EP - 179
JO - Therapeutic Advances in Gastroenterology
JF - Therapeutic Advances in Gastroenterology
IS - 2
ER -