SNFGE SNFGE
 
Thématique :
- Endoscopie/Imagerie
Originalité :
Intermédiaire
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Docteur Edouard Chabrun
Coup de coeur :
 
 
Gastroenterology
  2018/04  
 
  2018 Apr;154(5):1352-1360.e3.  
  doi: 10.1053/j.gastro.2018.01.003.  
 
  Increasing Rates of Surgery for Patients With Nonmalignant Colorectal Polyps in the United States.  
 
  Peery AF, Cools KS, Strassle PD, McGill SK, Crockett SD, Barker A, Koruda M, Grimm IS  
  https://www.ncbi.nlm.nih.gov/pubmed/29317277  
 
 

Abstract

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

 

 
Question posée
 
Augmentation du taux de chirurgie pour polypes colo-rectaux non néoplasiques dans la population des Etats-Unis.
 
Question posée
 
Etude rétrospective reprenant tous les cas nord-américains de colectomie entre 2000 et 2014, pour cancer et pour lésions non néoplasiques. Le nombre de chirurgie pour non-cancer a augmenté de 5.9 à 9.4 pour 100000 adultes de 2000 à 2014 alors que le nombre de chirurgie pour cancer a diminué de 31.5 à 24.7 pour 100000 adultes pour la même période.
 
Commentaires

Alors que les techniques endoscopiques s’améliorent, que le matériel évolue, il est étrange de voir une telle évolution aux Etats-Unis. Cela signifie que le nombre de chirurgie pour polypes colo-rectaux est trop important, et que l’endoscopie thérapeutique n’a pas encore trouvé la place qu’elle mérite.

 
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