목적: 대장내시경 검사는 대장 질환의 진단 및 선별검사에 있어서 표준이 되는 검사이다. 그러나, 고령인 경우 안전성에 대한 우려 때문에 검사를 기피하게 되는 경우가 있다. 따라서, 본 저자들은 80세 이상의 노인에서 대장내시경 검사의 안전성과 유용성에 대해 알아보고자 한다. 대상 및 방법: 후향적 연구로 2000년 1월부터 2007년 4월까지 삼성 서울병원에서 대장내시경 검사를 받은 80세 이상의 환자 444명 중 대장 수술력이 있는 경우, 용종 제거를 위해 검사한 경우 등을 제외한 170명을 대상으로 하였다. 대조군은 환자군과 동일한 성비로 무작위 추출을 한 후 같은 제외기준을 적용하여 채택한 50세 이상 70세 미만의 환자 179명을 대상으로 하였으며, 두 군에서 대장내시경 소견, 삽입 성공률 및 합병증의 비율을 비교하였다. 결과: 80세 이상 환자군 나이의 중앙값은 82세(범위: 80∼92세)였으며, 남자가 125명(73.5%)이었다. 임상적으로 의미 있는 소견은 55.9% (95/170), 삽입 성공률은 94.7% (161/170), 검사와 관련된 합병증은 없었다. 50세 이상 환자군 나이의 중앙값은 58세(범위: 50∼69세)였으며, 남자가 110명(61.5%)이었다. 임상적으로 의미 있는 소견은 37.4% (67/179), 삽입 성공률은 96.6% (173/179), 검사와 관련된 합병증은 없었다. 임상적으로 의미 있는 소견은 80세 이상의 환자군에서 유의하게 높았으며(p=0.001), 성별에 따라 두 군을 비교했을 때, 남성 및 여성 각각의 80세 이상 환자군에서도 동일한 결과를 보였다(p=0.01). 그리고, 삽입 성공률 및 합병증은 통계적으로 유의한 차이가 없었다. 결론: 80세 이상의 노인에서 대장내시경 검사는 유용한 검사로 안전하게 시행될 수 있을 것으로 판단한다.

Background/Aims: Optical colonoscopy is considered the gold standard for conducting a colorectal examination. Yet clinicians are often reluctant to refer elderly patients for colonoscopy because of their perception that it is a risky procedure. The aim of this study was to establish the efficacy and safety of performing colonoscopy in patients 80 years of age and older. Methods: The study data was retrospectively collected from January 2000 to April 2007. Comparisons were made between two groups: The patients were classified based on age: 50~69 years and ≥80 years of age. We collected data on sedation, the total colonoscopy rates, the indication, the colonoscopic findings and the complications. Results: Three hundred and forty-nine patients (170 elderly patients and 179 patients aged 50~69 years) were enrolled. Compared to the patients aged 50~69 years, the elderly patients had more clinically significant findings (55.9% for the elderly patient and 37.4% for the patients aged 50~80 years). Cecal intubation was done at a similar rate for both groups (94.7% and 96.6%, respectively). Although the elderly patients usually had one or more co-morbid illnesses (p＜0.001), the complication rate was not different between the 2 groups. Conclusions: Colonoscopy in the elderly is safe and effective and it allows physicians to discover many significant findings.

Background/Aims: Optical colonoscopy is considered the gold standard for conducting a colorectal examination. Yet clinicians are often reluctant to refer elderly patients for colonoscopy because of their perception that it is a risky procedure. The aim of this study was to establish the efficacy and safety of performing colonoscopy in patients 80 years of age and older. Methods: The study data was retrospectively collected from January 2000 to April 2007. Comparisons were made between two groups: The patients were classified based on age: 50~69 years and ≥80 years of age. We collected data on sedation, the total colonoscopy rates, the indication, the colonoscopic findings and the complications. Results: Three hundred and forty-nine patients (170 elderly patients and 179 patients aged 50~69 years) were enrolled. Compared to the patients aged 50~69 years, the elderly patients had more clinically significant findings (55.9% for the elderly patient and 37.4% for the patients aged 50~80 years). Cecal intubation was done at a similar rate for both groups (94.7% and 96.6%, respectively). Although the elderly patients usually had one or more co-morbid illnesses (p＜0.001), the complication rate was not different between the 2 groups. Conclusions: Colonoscopy in the elderly is safe and effective and it allows physicians to discover many significant findings.

Colonoscopy, Elderly, Efficacy, Safety