Morbidity and mortality after surgery for nonmalignant colorectal polyps

Gastrointest Endosc. 2018 Jan;87(1):243-250.e2. doi: 10.1016/j.gie.2017.03.1550. Epub 2017 Apr 10.


Background and aims: Despite evidence that most nonmalignant colorectal polyps can be managed endoscopically, a substantial proportion of patients with a nonmalignant colorectal polyp are still sent to surgery. Risks associated with this surgery are not well characterized. We describe 30-day postoperative morbidity and mortality and explore risk factors for adverse events in patients undergoing surgical resection for nonmalignant colorectal polyps.

Methods: We analyzed data collected prospectively as part of the National Surgical Quality Improvement Program. Our analysis included 12,732 patients who underwent elective surgery for a nonmalignant colorectal polyp from 2011 through 2014. We report adverse events within 30 days of the index surgery. Modified Poisson regression was used to estimate risk ratios and 95% confidence intervals.

Results: Thirty-day mortality was .7%. The risk of a major postoperative adverse event was 14%. Within 30 days of resection, 7.8% of patients were readmitted and 3.6% of patients had a second major surgery. The index surgery resulted in a colostomy in 1.8% and ileostomy in .4% of patients. Patients who had surgical resection of a nonmalignant polyp in the rectum or anal canal compared with the colon had a risk ratio of 1.58 (95% confidence interval, 1.09-2.28) for surgical site infection and 6.51 (95% confidence interval, 4.97-8.52) for ostomy.

Conclusions: Surgery for a nonmalignant colorectal polyp is associated with significant morbidity and mortality. A better understanding of the risks and benefits associated with surgical management of nonmalignant colorectal polyps will better inform discussions regarding the relative merits of management strategies.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colectomy*
  • Colonic Polyps / surgery*
  • Colorectal Neoplasms / surgery*
  • Colostomy / statistics & numerical data
  • Databases, Factual
  • Digestive System Surgical Procedures
  • Elective Surgical Procedures
  • Female
  • Humans
  • Ileostomy / statistics & numerical data
  • Intestinal Polyps / surgery
  • Male
  • Middle Aged
  • Morbidity
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / mortality
  • Rectum / surgery
  • Retrospective Studies
  • Surgical Wound Infection / epidemiology