From the Journals

Nonendoscopic nonmalignant polyp surgery increasing despite greater risk


Key clinical point: Surgical resections for nonmalignant colorectal polyps are increasing while safer endoscopic procedures are available.

Major finding: Incidence rate of surgery for nonmalignant polyps has increased from 5.9 to 9.4 per 100,000 adults from 2000 to 2014.

Study details: A retrospective study of 1,230,458 surgeries recorded in the Healthcare Cost and Utilization Project National Inpatient Sample from 2000 to 2014.

Disclosures: The authors reported no relevant financial disclosures.

Source: Peery A et al. Gastroenterology. 2018 Jan 6. doi: 10.1053/j.gastro.2018.01.003.



Rate of nonendoscopic surgeries for nonmalignant colorectal polyps significantly increased from 5.9 to 9.4 per 100,000 people from 2000 to 2014, according to a study in Gastroenterology.

These surgeries are not only associated with a much higher risk to patients than endoscopic procedures, but they are significantly less cost effective, confusing investigators as to the cause of the increase.

“The literature to date is clear that endoscopic resection is the preferred management of nonmalignant colorectal polyps,” Anne Peery, MD, gastroenterologist at the University of North Carolina at Chapel Hill, and colleagues explained. “Among patients who have surgery for a nonmalignant colorectal polyp, 14% will have at least one major short-term postoperative event.”

Data from 1,230,458 surgeries conducted during 2000-2014 and recorded in the Healthcare Cost and Utilization Project National Inpatients Sample were included in this study. Patients who underwent a nonendoscopic procedure for nonmalignant polyps were predominantly non-Hispanic white, covered by Medicare, from the highest household income range, and an average age of 66 years.

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