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Otsuka Y, Akahoshi K, Yasunaga K, Kubokawa M, Gibo J, Osada S, Tokumaru K, Miyamoto K, Sato T, Shiratsuchi Y, Oya M, Koga H, Ihara E, Nakamura K. Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer. World J Gastrointest Oncol 2017; 9:416-422. [PMID: 29085568 PMCID: PMC5648985 DOI: 10.4251/wjgo.v9.i10.416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/24/2017] [Accepted: 08/04/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the clinical outcome of endoscopic submucosal dissection using the Clutch Cutter (ESDCC) in older patients.
METHODS We reviewed 232 consecutive patients with early gastric cancer who underwent ESDCC between June 2010 and February 2014 at Aso Iizuka Hospital. We divided patients into two groups according to age: Older patients (> 80 years, n = 64) and non-older patients (≤ 80 years, n = 168). We retrospectively compared the prevalence rates of pre-existing comorbidities, anticoagulant therapy, en bloc resection, mean duration of hospitalization, incidence of ESDCC-related complications, change in performance status (PS) before and after ESDCC, and financial cost of admission.
RESULTS The older group comprised 64 patients with a mean age of 84.1 years, and the non-older group comprised 168 patients with a mean age of 69.5 years. Older patients had significantly more pre-existing comorbidities than did non-older patients, specifically heart disease (P < 0.05). The en bloc resection rate in non-older patients was significantly higher than that in older patients (100% vs 95.3%, P = 0.02). There were no significant differences between the older and non-older groups in the incidence of ESDCC-related complications (i.e., postoperative bleeding and perforation) and the post-ESDCC change in PS. There were also no significant differences between the older and non-older groups in the mean duration of hospitalization (11.4 and 10.7 d, respectively) and financial cost of admission (657040 JPY and 574890 JPY, respectively).
CONCLUSION ESDCC has a good clinical outcome in older patients.
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Affiliation(s)
- Yoshihiro Otsuka
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Kazuya Akahoshi
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Kayoko Yasunaga
- Diagnosis Procedure Combination Coding Management Office, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Masaru Kubokawa
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Junya Gibo
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Shigeki Osada
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Kayo Tokumaru
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Kazuaki Miyamoto
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Takao Sato
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Yuki Shiratsuchi
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Masafumi Oya
- Department of Pathology, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Hidenobu Koga
- Clinical Research Supportive Office, Aso Iizuka Hospital, Iizuka 820-8505, Japan
| | - Eikichi Ihara
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Kazuhiko Nakamura
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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