{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:30Z","timestamp":1787004870118,"version":"build-2736575974"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Endoscopic submucosal dissection (ESD) has emerged as the standard treatment for colorectal lesions. Considering aging of the global population, we aimed to assess effectiveness and safety of colorectal ESD in patients aged \u2265 80 years compared with those aged 65 to 79 years in a large Western cohort.<\/jats:p>\n                  <jats:p>We retrospectively enrolled patients aged &gt; 64 years undergoing colorectal ESD, classifying them into a very elderly group (VE-Group, aged &gt; 80 years) and elderly group (E-Group, 65\u201379 years). Procedure outcomes and safety were compared between the VE-Group and E-Group and between patients with comorbidities and those who were healthy (1-CM-Group and H-Group).<\/jats:p>\n                  <jats:p>A total of 980 patients were included (269; 27.5% in the VE-Group and 711; 72.5% in the\n        E-Group). En-bloc, R0, and oncological curative resection rates did not differ, nor did\n        intra-procedure or post-procedure adverse events (AEs). Delirium occurrence was registered\n        in VE-group [6 (2.2%) in VE-Group vs 1 (0.1%) in E-Group; P =\n        0.001; OR = 16.2, (95%CI:1.9\u2013135.2)]. The 1-CM-Group had a higher rate of intra-procedure\n        bleeding (P = 0.001), delayed perforation (P = 0.03), fever onset (P &lt; 0.001), and systemic\n        infections (P = 0.02) compared with the H-Group. Having one or\n        more comorbidities was associated with increased overall AEs (P\n        &lt; 0.001; OR 2.3, 95% CI 1.5\u20133.6).<\/jats:p>\n                  <jats:p>Colorectal ESD is feasible in elderly patients. Physicians should consider delirium a possible AE in patients older than age 80 years. These findings, which bridge the gap between Asian and Western clinical data, underscore the importance of tailored pre-procedure and post-procedure assessments in a global clinical context.<\/jats:p>","DOI":"10.1055\/a-2568-1366","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T22:59:41Z","timestamp":1743116381000},"source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Impact of age and comorbidities on colorectal endoscopic submucosal dissection outcomes: Large multicenter study in a Western cohort"],"prefix":"10.1055","volume":"13","author":[{"given":"Sandro","family":"Sferrazza","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, ARNAS Civico Di Cristina Benfratelli, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0802-3173","authenticated-orcid":false,"given":"Giulio","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, ARNAS Civico Di Cristina Benfratelli, Palermo, Italy"},{"name":"Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4992-9289","authenticated-orcid":false,"given":"Marcello","family":"Maida","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Kore University of Enna, Enna, Italy"},{"name":"Gastroenterology Unit, Ospedale Umberto I Enna, Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2212-2266","authenticated-orcid":false,"given":"Antonio","family":"Capogreco","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6448-2649","authenticated-orcid":false,"given":"Roberto","family":"de Sire","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy"},{"name":"Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1870-5952","authenticated-orcid":false,"given":"Paolo","family":"Cecinato","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romano","family":"Sassatelli","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"De Roberto","sequence":"additional","affiliation":[{"name":"Division of Endoscopy, European Institute of Oncology, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Barbaro","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Spada","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Francesco","family":"Chiappetta","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Operative Digestive Endoscopy Unit, Niguarda Hospital, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cutolo","sequence":"additional","affiliation":[{"name":"Operative Digestive Endoscopy Unit, Niguarda Hospital, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Manno","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Ramazzini Hospital, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Soriani","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Ramazzini Hospital, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Rosa Rizzotto","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, St. Antonio Hospital, Azienda Ospedaliera Universitaria, Padova, Italy, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Gubbiotti","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, St. Antonio Hospital, Azienda Ospedaliera Universitaria, Padova, Italy, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Andrisani","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Campus Bio-Medico University Hospital, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Campus Bio-Medico University Hospital, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Azzolini","sequence":"additional","affiliation":[{"name":"Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"},{"name":"Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Di Mitri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, ARNAS Civico Di Cristina Benfratelli, 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