Rates of colorectal surgery in patients with non-malignant colorectal polyps: Results from a nationwide study

TL;DR

This study shows that surgeries for non-cancerous colorectal polyps have decreased over the past decade, with fewer complications compared to cancer surgeries.

Contribution

The study provides nationwide data on trends and outcomes of surgeries for non-malignant colorectal polyps in the U.S.

Findings

38.4% of colorectal surgeries were for non-malignant polyps between 2013 and 2023.

The proportion of surgeries for non-malignant polyps dropped from 59% in 2013 to 33% in 2023.

NMCRP surgeries had lower risks of various postoperative adverse events compared to cancer surgeries.

Abstract

Despite advances in endoscopic techniques, many colorectal surgeries in the United States are still performed for non-malignant colorectal polyps (NMCRPs). This study evaluated trends, demographic variations, and outcomes of surgeries for NMCRPs among all colorectal surgeries over the past decade. Using the TriNetX nationwide database, we identified adults (≥ 18 years of age) who underwent colectomy or proctectomy for NMCRPs or colorectal cancer between 2013 and 2023. We evaluated the proportion of surgeries performed for NMCRPs, stratified by demographic factors, and compared postoperative adverse events (AEs) between NMCRP and colorectal cancer surgeries. Among 136,721 surgeries, 52,480 (38.4%) were for NMCRPs. The proportion of NMCRP surgeries decreased from 59% in 2013 to 33% in 2023, with the most significant decline between 2013 and 2016. Black individuals showed the highest decrease. Compared with colorectal cancer surgeries, NMCRP surgeries were associated with significantly lower risks of wound, infectious, urinary, pulmonary, gastrointestinal, and cardiac AEs. Although the proportion of NMCRP surgeries has declined, ongoing efforts in education and training are needed to further reduce unnecessary surgeries and improve patient outcomes.

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