Metin UZMAN, Zeynep GÖKTAŞ, Ferdane PİRİNÇÇİ SAPMAZ, Muhammet Yener AKPINAR, Yaşar NAZLIGÜL, Evrim Kahramanoğlu Aksoy

Geriatrik Hastalarda Üst Gastrointestinal Sistem Endoskopisinin Etkinlik ve Güvenilirliğinin Değerlendirilmesi

Amaç: Üst gastrointestinal sistem (GİS) endoskopisi diğer hastalarda olduğu gibi geriatrik hastalarda da önemli bir tanısal ve terapötik araçtır. Bizbu çalışmada geriatrik hastalarımızda yapılan üst GİS endoskopi işlemlerinin endikasyonlarını, endoskopide tanı alan lezyonların sıklığını ve bu yaşgrubunun mide patolojilerinin değerlendirilmesini amaçladık.Gereç ve Yöntem: Bu çalışmaya Sağlık Bilimleri Üniversitesi, Keçiören Eğitim ve Araştırma Hastanesi, Gastroenteroloj Bilim Dalı Endoskopi Ünitesinde1 Ocak 2017-1 Ocak 2018 tarihleri arasında üst gastrointestinal sistem endoskopisi yapılan 65 yaş ve üzeri hastalar retrospektif olarak dahil edildi.Çalışmaya alınan hastalar yaşlarına göre iki gruba ayrıldı: 65-80 yaş arası grup 1 ve 80 yaş üzeri grup 2.Bulgular: Çalışmaya toplam 1154 hasta (yaş ortalaması 74.2±6,38, erkek/kadın: 44,7/55,3) alındı. Bu hastaların 1018 tanesinden endoskopiesnasında biyopsi ve/veya doku örneklemesi yapıldı. En sık endoskopi endikasyonu dispepsi (%86,3) idi. Gastrit (%81,5) ve alt özofagus sfinkter(AÖS) gevşekliği (%34) en sık izlenen endoskopik bulgularken mide kanseri %1,4, peptik ülser %1,1 sıklıkta izlendi. Hastalarımızda H. pylori sıklığı%41,7’ydi. Endoskopi endikasyonları, endoskopik bulgular ve H. pylori varlığı gruplar arasında anlamlı farklılık göstermedi. Hastalarımızın hiçbirindetanısal ve terapötik üst GİS endoskopisine bağlı olarak komplikasyon ve mortalite izlenmedi.Sonuç: Geriatrik hastalarda üst GİS endoskopisi, hastalar çok ileri yaş olsalar dahi tanısal ve terapötik amaçla güvenli bir şekilde kullanılabilir. Yaştek başına endoskopi işlemine karar vermede yönlendirici olmamalıdır.

Objectives: Upper gastrointestinal system (GIS) endoscopy is an important diagnostic and therapeutic tool in geriatric patients, similarly to other age groups. Here we aimed to present the indications, endoscopic and pathologic findings and also endoscopy related complications of upper endoscopic procedures in our geriatric population. Materials and Methods: This study was designed as a retrospective study. Patients over 65 years old who had either diagnostic and/or therapeutic upper gastrointestinal system endoscopy between 1 January 2017-1 January 2018 in Kecioren Training and Research Hospital were enrolled into the study. Based on their age, patients were divided into two subgroups: group 1: patients aged between 65-80 years old and group 2: Patients aged over 80 years old. Results: Overall 1154 patients (median age 74.2±6.38, male/female: 44.7/55.3) were enrolled into the study. Tissue biopsy was performed in 1018 patients. The most frequent upper GIS endoscopy indication was dyspepsia (86.3%). Gastritis (81,5%) and lower esophageal sphincter (LES) relaxation (34%) were the most frequent endoscopic findings. Nevertheless the frequency of gastric cancer and peptic ulcer were 1.4% and 1.1%, respectively. The frequency of H. pylori in our patients was 41.7%. Between two groups, endoscopy indications, endoscopic findings and frequency of H. pylori were not significantly different. We did not observe any complication and upper GIS endoscopy associated mortality in our patients.Conclusion: Upper GIS endoscopy can be perform in terms of diagnostic or therapeutic with safely in geriatric patients even if patient is extremely elder. Age, alone must not a router to decide upper GIS endoscopy in geriatric patient.

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