More on Bad Outcomes After Surgery for Benign Colon Polyps

More on Bad Outcomes After Surgery for Benign Colon Polyps

Douglas K. Rex, MD, FASGE reviewing Ma C, et al. Am J Gastroenterol 2019 Oct 11. 

Recent studies have established that surgery for benign colon polyps is associated with higher morbidity, mortality, and costs compared to endoscopic resection, but rates of surgical resection for benign polyps have remained stable in the U.S. 

In a new study of 262,843 surgeries for benign colon polyps from the National Inpatient Sample in the years 2005 to 2014, the overall mortality rate was 0.8%. The rate of inpatient death was 0.2% in 50- to 59-year-olds, 0.6% in 60- to 69-year-olds, 1.0% in 70- to 79-year-olds, and 2.5% in persons ≥80 years. The overall risk of death in patients undergoing open surgery was 1.1% compared to 0.4% for laparoscopic surgery.

Postoperative morbidity, including wound issues, infections, and urinary, pulmonary, gastrointestinal, and cardiovascular events occurred in 25.3% of patients. A postoperative event increased the mean length of stay from 5.0 to 10.3 days and the mean cost of hospitalization from $40,258 to $77,015.

This is the second recent large study to report a U.S. mortality rate of nearly 1% for surgical resection of benign colon polyps. The major morbidity rate in the study was significantly higher than that in the other recent large study. Together, these results indicate that patients with benign colon polyps should be referred to interventional endoscopists for consideration of endoscopic resection before resorting to surgical resection.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, FASGE


Ma C, Teriaky A, Sheh S, et al. Morbidity and mortality after surgery for nonmalignant colorectal polyps: a 10-year nationwide analysis. Am J Gastroenterol 2019 Oct 11. (Epub ahead of print) (

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