AimThe aim of this work was to evaluate the safety and feasibility of performing colonoscopy in patients aged 90 years or over.MethodIn compliance with PRISMA statement standards, a systematic review of studies reporting the outcomes of colonoscopy in patients aged ≥90 years was conducted. A proportional meta‐analysis model was constructed to quantify the risk of outcomes and a direct comparison meta‐analysis model was constructed to compare outcomes between nonagenarians and patients aged between 50 and 89 years via random‐effects models.ResultsSeven studies enrolling 1304 patients (1342 colonoscopies) were included. Analyses showed that complications related to bowel preparation occurred in 0.7% (95% CI 0.1%–1.6%), procedural complications in 0.6% (0.00%–1.7%), 30‐day complications in 1.5% (0.6%–2.7%), procedural mortality in 0.3% (0.0%–1.1%) and 30‐day mortality in 1.1% (0.3%–2.2%). Adequate bowel preparation and colonoscopy completion were achieved in 81.3% (73.8%–87.9%) and 92.1% (86.7%–96.3%), respectively. No difference was found in bowel preparation‐related complications [risk difference (RD) 0.00, p = 0.78], procedural complications (RD 0.00, p = 0.60), 30‐day complications (RD 0.01, p = 0.20), procedural mortality (RD 0.00, p = 1.00) or 30‐day mortality (RD 0.01, p = 0.34) between nonagenarians and patients aged between 50 and 89 years. The colorectal cancer detection rate was 14.3% (9.8%–19.5%), resulting in therapeutic intervention in 65.9% (54.5%–76.6%).ConclusionsAlthough the evidence is limited to a selected group of nonagenarians, it may be fair to conclude that if a colonoscopy is indicated in a nonagenarian with good performance status (based on initial less‐invasive investigations), the level 2 evidence supports its safety and feasibility. Age on its own should not be a reason for failing to offer colonoscopy to a nonagenarian.

中文翻译：

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九旬老人结肠镜检查的安全性和可行性：系统评价、荟萃分析和荟萃回归分析

目的本工作的目的是评估90岁及以上患者进行结肠镜检查的安全性和可行性。方法按照PRISMA声明标准，对报告90岁以上患者结肠镜检查结果的研究进行系统评价。构建了比例荟萃分析模型来量化结果风险，并构建了直接比较荟萃分析模型来通过随机效应模型比较九十多岁和年龄在 50 至 89 岁之间的患者的结果。 结果 七项研究纳入了 1304 名患者（1342结肠镜检查）也包括在内。分析显示，与肠道准备相关的并发症发生率为 0.7%（95% CI 0.1%–1.6%），手术并发症发生率为 0.6%（0.00%–1.7%），30 天并发症发生率为 1.5%（0.6%–2.7%） ，手术死亡率为 0.3%（0.0%–1.1%），30 天死亡率为 1.1%（0.3%–2.2%）。充分的肠道准备和结肠镜检查完成率分别为 81.3% (73.8%–87.9%) 和 92.1% (86.7%–96.3%)。肠道准备相关并发症没有发现差异[风险差 (RD) 0.00，p= 0.78]，手术并发症（RD 0.00，p= 0.60），30 天并发症（RD 0.01，p= 0.20），手术死亡率（RD 0.00，p= 1.00）或 30 天死亡率（RD 0.01，p= 0.34）九十多岁的人和年龄在 50 岁到 89 岁之间的患者。结直肠癌检出率为 14.3% (9.8%–19.5%)，治疗干预率为 65.9% (54.5%–76.6%)。 结论 尽管证据仅限于选定的九十多岁人群，但可以公平地得出结论：如果对具有良好体能状态的九十多岁老人进行结肠镜检查（基于最初的微创检查），则 2 级证据支持其安全性和可行性。年龄本身不应成为未能为九十多岁的老人提供结肠镜检查的理由。