The Feasibility and Safety of Endoscopic Submucosal Dissection for Gastric Neoplasm in Elderly Korean Patients / 대한소화기내시경학회지

BACKGROUND/AIMS: Elderly patients often have high operative risk due to their comorbid diseases, and the feasibility of performing endoscopic submucosal dissection (ESD) for such patients should be investigated. The aim of this study is to evaluate the efficacy and safety of performing ESD in elderly patients. METHODS: From 2005 to 2007, 269 patients with gastric neoplasm were treated by ESD in our hospital. These patients were divided into the elderly patients who were 65 years of age or older and the younger patients. The number of enrolled elderly patients was 123. The en bloc complete resection rate and the complications were assessed and compared with those of the younger patients. RESULTS: The average age of the old age group of patients was 71.1. Of these patients, 53.7% had comorbid diseases and 51.2% revealed adenocarcinoma. The en bloc plus complete resection rate was 85.4%. Perforation during ESD occurred in 4.1% of the patients, and this was immediately closed with endoclips and then it was managed by conservative medical treatment. Bleeding occurred in 17.9% and there were no patients with severe bleeding. The en bloc plus complete resection rate and the complication rate for the elderly patients were not significantly different from those of the younger patients. CONCLUSIONS: The present study shows that ESD could be a safe and reliable treatment for gastric neoplasms in elderly patients.

A Case of Anti-Hu Associated Paraneoplastic Subacute Sensory Neuronopathy

Subacute sensory neuronopathy usually occurs as a paraneoplastic syndrome, occurring most frequently in small cell lung cancer. We report a 63-year-old male presenting typical symptoms of subacute sensory neuronopathy. Electrophysiologic studies showed diffuse sensory axonal degeneration and anti-Hu antibody was positive in his serum. We reevaluated pulmonary lesions formerly diagnosed as active pulmonary tuberculosis. Chest computed tomography showed two nodules and hilar lymphadenopathy, and by percutaneous needle biopsy, small cell lung cancer was diag-nosed.