Introduction Patients diagnosed with complex colonic polyps (broad based, crossing two haustral folds, or being located at the ileocaecal valve or colonic flexures) unsuitable for endoscopic treatment undergo the same surgical procedure as patients with colon cancer. As a result of the bowel cancer screening programmes, the number of these patients has increased significantly and outcomes after hemicolectomy for benign colonic polyps (BCP) are poorly documented. We present a case-matched study examining short-term outcomes of patients with BCP versus those with colonic cancer (CC) from two institutions.
Methods Consecutive patients undergoing surgery for BCP were identified in two hospitals from prospectively maintained databases (data collection period 2005–2006 and 2010–2012 respectively). Hospital coding database was also searched using operation codes to identify missing patients. Each patient was matched for age, sex, ASA grade, site and type of resection (laparoscopic, open, and converted) to two controls undergoing surgery for treatment of CC identified in each centre. The length of stay (LOS) and 30-day outcomes were analysed with further adjustments for BMI, blood loss and operation time. Multilevel linear and logistic regression analyses were performed.
Results 46 BCP patients were matched with 81 CC patients. Almost all procedures were performed laparoscopically (42/46). Two procedures were converted to open and two patients underwent planned open surgery. Median size of BCP was 4 cm (IQR 2.5, 5.4). BCP group had a marginally longer LOS [median 5.5 days (IQR 4, 8) and 5 days (IQR 3, 7) respectively (p = 0.04)]. 21/46 (46%) patients with BCP had a postoperative complication compared to 25/81 (31%) CC patients (p = 0.12, OR = 2.11; CI 0.82–5.41). 4/46 (9%) BCP patients underwent reoperation and further 3/46 (7%) were readmitted versus 1/81 (1%) and 2/81 (2%) in CC group (p = 0.07 and 0.28 respectively). No deaths were observed in either group.
Conclusion Complications following segmental colectomy for complex colonic polyps are not significantly different to those after cancer surgery. The results of this study provide further impetus for the development of a local full thickness colonic excision technique as an alternative, less invasive treatment option in order to improve patient outcomes.
Disclosure of Interest None Declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.