University of North Carolina School of Medicine, Chapel Hill, North Carolina.
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Gastroenterology. 2018 Apr;154(5):1352-1360.e3. doi: 10.1053/j.gastro.2018.01.003. Epub 2018 Jan 6.
BACKGROUND & AIMS: Despite the availability of endoscopic therapy, many patients in the United States undergo surgical resection for nonmalignant colorectal polyps. We aimed to quantify and examine trends in the use of surgery for nonmalignant colorectal polyps in a nationally representative sample.
We analyzed data from the Healthcare Cost and Utilization Project National Inpatient Sample for 2000 through 2014. We included all adult patients who underwent elective colectomy or proctectomy and had a diagnosis of either nonmalignant colorectal polyp or colorectal cancer. We compared trends in surgery for nonmalignant colorectal polyps with surgery for colorectal cancer and calculated age, sex, race, region, and teaching status/bed-size-specific incidence rates of surgery for nonmalignant colorectal polyps.
From 2000 through 2014, there were 1,230,458 surgeries for nonmalignant colorectal polyps and colorectal cancer in the United States. Among those surgeries, 25% were performed for nonmalignant colorectal polyps. The incidence of surgery for nonmalignant colorectal polyps has increased significantly, from 5.9 in 2000 to 9.4 in 2014 per 100,000 adults (incidence rate difference, 3.56; 95% confidence interval 3.40-3.72), while the incidence of surgery for colorectal cancer has significantly decreased, from 31.5 to 24.7 surgeries per 100,000 adults (incidence rate difference, -6.80; 95% confidence interval -7.11 to -6.49). The incidence of surgery for nonmalignant colorectal polyps has been increasing among individuals age 20 to 79, in men and women and including all races and ethnicities.
In an analysis of a large, nationally representative sample, we found that surgery for nonmalignant colorectal polyps is common and has significantly increased over the past 14 years.
尽管内镜治疗已经普及，但在美国仍有许多非恶性结直肠息肉患者接受手术切除。本研究旨在量化并分析美国人群中非恶性结直肠息肉手术的使用情况和趋势。
我们分析了 2000 年至 2014 年期间美国医疗保健成本和利用项目全国住院患者样本的数据。纳入标准为接受择期结肠切除术或直肠切除术且诊断为非恶性结直肠息肉或结直肠癌的所有成年患者。我们比较了非恶性结直肠息肉手术与结直肠癌手术的趋势，并计算了非恶性结直肠息肉手术的年龄、性别、种族、地区和教学状态/床位数特定发生率。
2000 年至 2014 年期间，美国共有 1230458 例非恶性结直肠息肉和结直肠癌手术。其中，25%的手术为非恶性结直肠息肉。非恶性结直肠息肉手术的发病率显著增加，从 2000 年的每 10 万人 5.9 例增加到 2014 年的每 10 万人 9.4 例（发病率差异为 3.56；95%置信区间为 3.40-3.72），而结直肠癌手术的发病率则显著下降，从 2000 年的每 10 万人 31.5 例降至 2014 年的每 10 万人 24.7 例（发病率差异为-6.80；95%置信区间为-7.11 至-6.49）。20-79 岁人群、男性和女性、所有种族和族裔的非恶性结直肠息肉手术发病率均在增加。
在一项基于大型全国代表性样本的分析中，我们发现非恶性结直肠息肉手术较为常见，且在过去 14 年中显著增加。
