New Data Indicate That Surgery Rates for Benign Polyps Might Be Finally Declining
Douglas K. Rex, MD, MASGE, reviewing Kruger AJ, et al. Am J Gastroenterol 2021 Jul 13.
Several recent studies have collectively reported that surgery rates for benign colorectal polyps in the U.S. have continued to increase even though surgery results in more mortality, morbidity, and cost than endoscopic resection.
Evaluating 2010 to 2014 and 2016 to 2018 data from the Nationwide Readmissions Database, the authors identified about 164,000 persons undergoing surgery for benign polyps, with index admission mortality rates of 0.3% to 0.4%. Postoperative morbidity and 30-day readmission rates were 20.5% and 8.5% in the first period and 13.0% and 7.6% in the second period, respectively. In both periods, male sex, ≥3 comorbidities, Medicare or Medicaid insurance, and open surgery (vs laparoscopic) predicted an increased risk of postoperative morbidity and 30-day readmission.
During the first interval, the number of surgeries for benign polyps increased gradually from 21,491 to 22,041 per year. In the 2016 to 2018 interval, the number of cases decreased from 19,209 in 2016 to 17,393 in 2018.
COMMENTThese data confirm many recently reported study results but suggest that the many calls to convert resections from surgical to endoscopic are beginning to be heard. Additional study will be needed to confirm this.
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.
CITATION(S)
Kruger AJ, Hussan H, Stanich PP, et al. Postoperative hospital outcomes of elective surgery for nonmalignant colorectal polyps: Does the burden justify the indication? Am J Gastroenterol 2021 Jul 13. (Epub ahead of print) (https://doi.org/10.14309/ajg.0000000000001374)
