ABSTRACT
Background/Aims@#Globally, the population aged 80 years or older is growing faster due to the rising life expectancy. Korea has already entered into an advanced aged society, and a post-aged society is expected in 2025. This study evaluated the patterns of gastrointestinal disease in the population aged 80 years or older during the recent decade in Korea.Method: This study retrospectively reviewed the medical records of patients admitted to the gastrointestinal department of Suwon St. Vincent’s hospital, Incheon St. Mary’s hospital, and Uijeongbu St. Mary's Hospital ― general hospitals of Seoul-Gyeonggi province in Korea. It was a repeated cross-sectional study in 2009 and 2019. @*Results@#The number of admitted patients aged 80 years or older increased from 549 (9.0%) in 2009 to 1,073 (14.4%) in 2019 (p<0.01). As for the in-hospital mortality, there was no significant difference (p=0.25). On the other hand, the combined morbidities increased, and the duration of admission also increased (7.2±7.8 days vs. 8.1±8.2 days, p=0.03). The number of upper gastrointestinal hemorrhage and patients who are bleeding associated with drugs users increased (p<0.01). The proportion of lower gastrointestinal disease decreased (p<0.01) because of the decrease in procedure-related admissions (p<0.01). The number of those with pancreaticobiliary tract disease increased markedly (p<0.01), and the rate of cases that could not perform the procedure decreased (p=0.04). @*Conclusion@#The patterns of gastrointestinal disease in the population aged 80 years or older have changed in the recent decade in Korea. Hence, more preparation for this medical environment is needed.
ABSTRACT
Treatment of choice for early gastric cancer has changed from curative surgery to endoscopic therapy. And the indications for endoscopic treatment of early gastric cancer are expanded. A 70-year-old man was referred for further management of early gastric cancer. In endoscopy, early gastric cancer was suspected at antrum, greater curvature side of gastric body. Endoscopic submucosal dissection was performed. Histology revealed a 6.9×2.7-cm-sized tubular adenocarcinoma, moderately differentiated type and resection margin was negative. Following endoscopy was performed annually. Histology has changed from chronic inflammation to chronic gastritis with intestinal metaplasia, tubular adenoma with low grade dysplasia, tubular adenoma with high grade dysplasia year by year. Laparoscopic subtotal gastrectomy with lymphadenectomy was performed. Histologic finding showed well differentiated tubular adenocarcinoma confined in mucosal layer without lymph node metastasis.