Our Summary

This study looked at the number of colectomies (a surgery to remove part or all of the colon) performed for non-cancerous polyps (abnormal growths) in the United States from 2013 to 2019. It found that a sizeable number of colectomies were performed for this reason, despite the fact that it was rare for these polyps to turn out to be cancerous. The study also found that these surgeries were associated with a significant rate of complications (21%) and a mortality rate of 0.5% (1% for patients older than 70). Over the study period, the percentage of colectomies performed for non-cancerous polyps decreased from 22% to 16%. The study suggests that more advanced, less invasive methods for dealing with non-cancerous polyps should be considered when possible.

FAQs

  1. What is the percentage of complications associated with colectomies performed for non-cancerous polyps according to the study?
  2. Has the percentage of colectomies performed for non-cancerous polyps increased or decreased from 2013 to 2019?
  3. What does the study suggest as an alternative to colectomy for dealing with non-cancerous polyps?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colectomy is to discuss alternative treatment options for non-cancerous polyps before considering surgery. It is important to weigh the potential risks and benefits of surgery and explore less invasive methods, such as endoscopic removal, if appropriate. Additionally, patients should be aware of the potential complications and mortality rates associated with colectomy and have a thorough discussion with their healthcare provider about the best course of action for their individual situation.

Suitable For

Patients who are typically recommended for colectomy include those with:

  1. Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease) that is not responding to other treatments.
  2. Colon cancer or other colorectal cancers.
  3. Severe diverticulitis (inflammation or infection of small pouches that can form in the colon).
  4. Familial adenomatous polyposis (a genetic condition that causes numerous polyps to form in the colon).
  5. Colonic inertia (a condition where the colon does not function properly, leading to severe constipation).
  6. Bowel obstruction or perforation.
  7. Severe bleeding from the colon.
  8. Precancerous polyps that are large, numerous, or have certain characteristics that increase the risk of developing into cancer.
  9. Chronic and severe gastrointestinal bleeding that cannot be controlled with other treatments.

Timeline

Before colectomy:

  1. Patient may experience symptoms such as abdominal pain, changes in bowel habits, rectal bleeding, or unexplained weight loss.
  2. Patient undergoes diagnostic tests such as colonoscopy, CT scan, or biopsy to determine the presence of polyps or other abnormalities in the colon.
  3. If non-cancerous polyps are found, patient may undergo surveillance colonoscopies to monitor their growth and potential risk of developing into cancer.
  4. If the polyps are deemed high-risk or causing symptoms, the patient’s healthcare team may recommend a colectomy surgery to remove part or all of the colon.

After colectomy:

  1. Patient undergoes the surgical procedure to remove the affected portion of the colon.
  2. Patient stays in the hospital for a few days to recover from the surgery and monitor for any complications.
  3. Patient may experience side effects such as pain, fatigue, changes in bowel habits, or temporary ileostomy or colostomy depending on the type of colectomy performed.
  4. Patient follows a special diet and takes medications as prescribed by their healthcare team to aid in recovery and prevent complications.
  5. Patient may undergo follow-up appointments and surveillance tests to monitor their colon health and ensure that the surgery was successful in removing the polyps.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a colectomy surgery for non-cancerous polyps?
  2. What are the alternative treatment options available for non-cancerous polyps in the colon?
  3. How likely is it that the non-cancerous polyps will turn out to be cancerous?
  4. What is the recovery process like after a colectomy surgery?
  5. How long will I need to stay in the hospital after the surgery?
  6. What long-term effects or changes in bowel habits can I expect after a colectomy?
  7. How often will I need follow-up screenings or surveillance after the surgery?
  8. Are there any lifestyle changes or dietary modifications I should consider after a colectomy?
  9. What is the success rate of colectomy surgery for non-cancerous polyps?
  10. What are the chances of the polyps recurring after the surgery?

Reference

Authors: Ozgur I, Liska D, Cengiz TB, Sapci I, Valente MA, Holubar SD, Steele SR, Bhatt A, Gorgun E. Journal: Am J Surg. 2022 Mar;223(3):463-467. doi: 10.1016/j.amjsurg.2021.11.030. Epub 2021 Dec 2. PMID: 34906364