# Elective colectomy for treatment of benign colon polyps: National surgical trends, outcomes, and cost analysis

## TL;DR

The study examines the rising trend of elective colectomies for benign colon polyps among veterans, highlighting increased rates, associated risks, and high costs.

## Contribution

The study provides national trends and outcomes of elective colectomies for benign colon polyps using a large veterans' database.

## Key findings

- Elective colectomies for benign polyps increased from 6% to 18% of all colectomies between 2000 and 2014.
- The 30-day mortality rate was 1.2%, and complication rate was 19.7% after colectomy for benign polyps.
- Median cost was $22,712 for open and $20,697 for laparoscopic colectomy, with higher costs if complications occurred.

## Abstract

Although endoscopic resection is recommended for management of complex benign colon polyps, patients are routinely referred for surgical resection. Little is known about the effects of these elective colectomies on patient outcomes. We sought to determine trends, surgical outcomes, and costs of elective colectomy for benign colon polyps.

We performed a retrospective cohort analysis of veterans nationwide using the National Veterans Affairs Surgical Quality Improvement Program (VASQIP) database linked to the national VA Corporate Data Warehouse database. We included all veterans (N = 7,102) undergoing elective colectomy for benign polyps from 2000 to 2015. Outcomes of interest were rates of colectomy, surgical pathology findings, morbidity, mortality, and costs.

Colectomy for benign polyps increased significantly from 6% of all colectomies in 2000 to 18% in 2014, and the percent of colectomies for colon cancer decreased from 40% to 31%. The 30-day mortality rate was 1.2% and the complication rate was 19.7%. Based on pathology, 80% of patients (n = 514) underwent right hemicolectomy, mean polyp size was 2.7 cm (± 1.7 cm), and 60.1% of resected polyps were adenomas. Median cost of colectomy was $22,712 for open and $20,697 for laparoscopic colectomy. Costs increased if a complication occurred.

Rates of colectomy for benign adenomas significantly increased from 2000 to 2014. Colectomy was associated with significant mortality, morbidity, and cost. Development of strategies to improve endoscopic management of benign large colon neoplasms is urgently needed.