Nationwide Assessment of Trends in Surgery for Non-Malignant Colorectal Polyps in the United States From 2000-2013
Introduction
Screening endoscopy (sigmoidoscopy and colonoscopy) with polypectomy reduces the incidence of and mortality from colorectal cancer.1-4 Most colorectal polyps are removed with routine endoscopic resection, although polyps considered to be complex because of size, location or morphology are commonly resected surgically.5-7 An estimated 1% of all patients with a non-malignant colorectal polyp will be sent for surgical resection.8-10 In the United States, 73,000 elective colectomies for colorectal cancer and non-malignant colorectal polyps are performed annually. Of these, 32% are performed on patients with non-malignant disease.9 Surgery for a non-malignant colorectal polyp is associated with significant morbidity, mortality and cost.9 …show more content…
There is emerging evidence that complex non-malignant colorectal polyps can be effectively and safely managed with advanced endoscopic resection. Advanced endoscopic resection has been shown to prevent the need for surgery in 92% of cases (6442 patients).11 Advanced endoscopic resection is associated with a reduced risk of adverse events and is more cost effective compared with surgical resection. Despite this paradigm shift in the management of non-malignant colorectal polyps, little is known about temporal trends in clinical practice. Understanding national, regional and hospital-level practice patterns has the potential to inform discussions regarding the relative merits of management strategies and to inform the impact on the health care
Introduction
Screening endoscopy (sigmoidoscopy and colonoscopy) with polypectomy reduces the incidence of and mortality from colorectal cancer.1-4 Most colorectal polyps are removed with routine endoscopic resection, although polyps considered to be complex because of size, location or morphology are commonly resected surgically.5-7 An estimated 1% of all patients with a non-malignant colorectal polyp will be sent for surgical resection.8-10 In the United States, 73,000 elective colectomies for colorectal cancer and non-malignant colorectal polyps are performed annually. Of these, 32% are performed on patients with non-malignant disease.9 Surgery for a non-malignant colorectal polyp is associated with significant morbidity, mortality and cost.9 …show more content…
There is emerging evidence that complex non-malignant colorectal polyps can be effectively and safely managed with advanced endoscopic resection. Advanced endoscopic resection has been shown to prevent the need for surgery in 92% of cases (6442 patients).11 Advanced endoscopic resection is associated with a reduced risk of adverse events and is more cost effective compared with surgical resection. Despite this paradigm shift in the management of non-malignant colorectal polyps, little is known about temporal trends in clinical practice. Understanding national, regional and hospital-level practice patterns has the potential to inform discussions regarding the relative merits of management strategies and to inform the impact on the health care