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Morbidity and mortality after surgery for nonmalignant colorectal polyps
Anne F Peery1, Nicholas J Shaheen1, Katherine S Cools2
1Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Gastrointestinal Endoscopy
|April 15, 2017
Summary
Surgery for nonmalignant colorectal polyps carries significant risks, including a 14% chance of major complications and a 0.7% mortality rate. Understanding these risks is crucial for choosing the best treatment strategy.
Area of Science:
- Colorectal surgery
- Gastroenterology
- Surgical quality improvement
Background:
- Most nonmalignant colorectal polyps can be managed endoscopically.
- A significant number of patients with nonmalignant polyps undergo surgery.
- Risks of surgical resection for nonmalignant polyps are not well-defined.
Purpose of the Study:
- To describe 30-day postoperative morbidity and mortality.
- To identify risk factors for adverse events in patients undergoing surgery for nonmalignant colorectal polyps.
Main Methods:
- Analysis of prospective data from the National Surgical Quality Improvement Program (NSQIP).
- Inclusion of 12,732 patients undergoing elective surgery for nonmalignant colorectal polyps (2011-2014).
- Use of modified Poisson regression to estimate risk ratios and confidence intervals for adverse events.
Main Results:
- 30-day mortality rate was 0.7%.
- 14% of patients experienced major postoperative adverse events.
- Rectal or anal canal polyp resections were associated with higher risks of surgical site infection (RR 1.58) and ostomy (RR 6.51) compared to colon resections.
Conclusions:
- Surgical resection of nonmalignant colorectal polyps is linked to considerable morbidity and mortality.
- Enhanced understanding of surgical risks and benefits is needed.
- Informed discussions on management strategies for nonmalignant colorectal polyps are essential.