{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:47:49Z","timestamp":1789832869346,"version":"4.0.1"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although endoscopic resection is recommended for management of complex benign colon polyps, patients are routinely referred for surgical resection. Little is known about the effects of these elective colectomies on patient outcomes. We sought to determine trends, surgical outcomes, and costs of elective colectomy for benign colon polyps.<\/jats:p><jats:p>We performed a retrospective cohort analysis of veterans nationwide using the National Veterans Affairs Surgical Quality Improvement Program (VASQIP) database linked to the national VA Corporate Data Warehouse database. We included all veterans (N = 7,102) undergoing elective colectomy for benign polyps from 2000 to 2015. Outcomes of interest were rates of colectomy, surgical pathology findings, morbidity, mortality, and costs.<\/jats:p><jats:p>Colectomy for benign polyps increased significantly from 6% of all colectomies in 2000 to 18% in 2014, and the percent of colectomies for colon cancer decreased from 40% to 31%. The 30-day mortality rate was 1.2% and the complication rate was 19.7%. Based on pathology, 80% of patients (n = 514) underwent right hemicolectomy, mean polyp size was 2.7 cm (\u00b1 1.7 cm), and 60.1% of resected polyps were adenomas. Median cost of colectomy was $22,712 for open and $20,697 for laparoscopic colectomy. Costs increased if a complication occurred.<\/jats:p><jats:p>Rates of colectomy for benign adenomas significantly increased from 2000 to 2014. Colectomy was associated with significant mortality, morbidity, and cost. Development of strategies to improve endoscopic management of benign large colon neoplasms is urgently needed.<\/jats:p>","DOI":"10.1055\/a-2689-5839","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T23:14:43Z","timestamp":1756163683000},"source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Elective colectomy for treatment of benign colon polyps: National surgical trends, outcomes, and cost analysis"],"prefix":"10.1055","volume":"13","author":[{"given":"Tonya","family":"Kaltenbach","sequence":"additional","affiliation":[{"name":"VA San Francisco, University of California, San Francisco, San Francisco, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Martin","sequence":"additional","affiliation":[{"name":"The University of Utah Health Sciences Center, Salt Lake City, United States"},{"name":"Specialty Care Center of Innovation, George E Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, United States"},{"name":"Surgery, George E Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6933-0791","authenticated-orcid":false,"given":"Jessica","family":"Yu","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Oregon Health Sciences University, Portland, United States"},{"name":"Medicine, Oregon Health & Science University, Portland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Brooke","sequence":"additional","affiliation":[{"name":"University of Utah Health, Salt Lake City, United States"},{"name":"Specialty Care Center of Innovation, George E Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, United States"},{"name":"Surgery, George E Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Peche","sequence":"additional","affiliation":[{"name":"University of Utah Health, Salt Lake City, United States"},{"name":"Surgery, George E Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Soetikno","sequence":"additional","affiliation":[{"name":"Gastroenterology, San Francisco VA Medical Center, San Francisco, United States"},{"name":"Medicine, University of California San Francisco, San Francisco, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Whooley","sequence":"additional","affiliation":[{"name":"Gastroenterology, San Francisco VA Medical Center, San Francisco, United States"},{"name":"Medicine, University of California San Francisco, San Francisco, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"Gawron","sequence":"additional","affiliation":[{"name":"Gastroenterology, University of Utah School of Medicine, Salt Lake City, United States"},{"name":"Gastroenterology, George E Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer statistics, 2024","volume":"74","author":"RL Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1038\/nrclinonc.2014.68","article-title":"Annual Report to the Nation on the status of cancer, 1975\u20132010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer","volume":"120","author":"BK Edwards","year":"2014","journal-title":"Cancer"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2355","DOI":"10.1056\/NEJMc1313116","article-title":"Colorectal-cancer incidence and mortality after screening","volume":"369","author":"R Nishihara","year":"2013","journal-title":"N Engl J Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1056\/NEJMp1600448","article-title":"Colorectal cancer on the decline--Why screening can\u2019t explain it all","volume":"374","author":"HG Welch","year":"2016","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1053\/j.gastro.2008.02.002","article-title":"Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology","volume":"134","author":"B Levin","year":"2008","journal-title":"Gastroenterology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1097\/MOG.0000000000000228","article-title":"How to deal with large colorectal polyps: snare, endoscopic mucosal resection, and endoscopic submucosal dissection; resect or refer?","volume":"32","author":"S Thirumurthi","year":"2016","journal-title":"Curr Opin Gastroenterol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1007\/s10350-007-9175-2","article-title":"Management of the difficult colon polyp referred for resection: resect or rescope?","volume":"51","author":"T Voloyiannis","year":"2008","journal-title":"Dis Colon Rectum"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1007\/s10350-004-6805-9","article-title":"Avoiding surgery in patients with colorectal polyps","volume":"46","author":"JM Church","year":"2003","journal-title":"Dis Colon Rectum"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.gie.2016.01.067","article-title":"Outcome of EMR as an alternative to surgery in patients with complex colon polyps","volume":"84","author":"GS Raju","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1016\/j.gie.2016.03.1508","article-title":"EMR should be the first-line treatment for large laterally spreading colorectal lesions","volume":"84","author":"EY Lee","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/j.cgh.2015.10.013","article-title":"Large sessile serrated polyps can be safely and effectively removed by endoscopic mucosal resection","volume":"14","author":"AK Rao","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/j.gie.2012.02.060","article-title":"Outcomes of EMR of defiant colorectal lesions directed to an endoscopy referral center","volume":"76","author":"AM Buchner","year":"2012","journal-title":"Gastrointest Endosc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/gutjnl-2014-308481","article-title":"Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis","volume":"65","author":"C Hassan","year":"2016","journal-title":"Gut"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2960","DOI":"10.1177\/00031348221091969","article-title":"Decreasing colectomy rates in advanced adenomas","volume":"89","author":"JD Mack","year":"2023","journal-title":"Am Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.gie.2016.01.048","article-title":"Adverse events after surgery for nonmalignant colon polyps are common and associated with increased length of stay and costs","volume":"84","author":"RN Keswani","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.gie.2017.03.1550","article-title":"Morbidity and mortality after surgery for nonmalignant colorectal polyps","volume":"87","author":"AF Peery","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"5392","DOI":"10.1007\/s00464-021-08858-4","article-title":"Management of the colonic polyps referred for surgery: an opportunity for improvement","volume":"36","author":"C Stockley","year":"2022","journal-title":"Surg Endosc"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/j.gie.2015.11.014","article-title":"Endoscopic resection is cost-effective compared with laparoscopic resection in the management of complex colon polyps: an economic analysis","volume":"83","author":"R Law","year":"2016","journal-title":"Gastrointest Endosc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.gie.2009.05.039","article-title":"Large refractory colonic polyps: is it time to change our practice? A prospective study of the clinical and economic impact of a tertiary referral colonic mucosal resection and polypectomy service (with videos)","volume":"70","author":"MP Swan","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.cgh.2015.08.037","article-title":"Cost analysis of endoscopic mucosal resection vs surgery for large laterally spreading colorectal lesions","volume":"14","author":"M Jayanna","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"2740","DOI":"10.1016\/j.cgh.2019.02.041","article-title":"Cost effectiveness of endoscopic resection vs transanal resection of complex benign rectal polyps","volume":"17","author":"JX Yu","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1097\/00000658-199810000-00006","article-title":"The Department of Veterans Affairs\u2019 NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program","volume":"228","author":"SF Khuri","year":"1998","journal-title":"Ann Surg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials","volume":"8","author":"KF Schulz","year":"2010","journal-title":"BMC Med"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1053\/j.gastro.2018.01.003","article-title":"Increasing rates of surgery for patients with nonmalignant colorectal polyps in the United States","volume":"154","author":"AF Peery","year":"2018","journal-title":"Gastroenterology"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1007\/s00464-020-07451-5","article-title":"Variation in colectomy rates for benign polyp and colorectal cancer","volume":"35","author":"JV Vu","year":"2021","journal-title":"Surg Endosc"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"E706","DOI":"10.1055\/a-1380-3017","article-title":"Overutilization of surgical resection for benign colorectal polyps: analysis from a tertiary care center","volume":"9","author":"R Saade","year":"2021","journal-title":"Endosc Int Open"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2121","DOI":"10.1007\/s00464-021-08499-7","article-title":"\u201cUnresectable\u201d polyp management utilizing advanced endoscopic techniques results in high rate of colon preservation","volume":"36","author":"CJ Wickham","year":"2022","journal-title":"Surg Endosc"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1053\/j.gastro.2011.02.062","article-title":"Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia","volume":"140","author":"A Moss","year":"2011","journal-title":"Gastroenterology"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1038\/ajg.2017.409","article-title":"Quality matters: Improving the quality of care for patients with complex colorectal polyps","volume":"113","author":"I Grimm","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.gie.2013.06.034","article-title":"Outcomes of repeat colonoscopy in patients with polyps referred for surgery without biopsy-proven cancer","volume":"79","author":"S Friedland","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1016\/j.jamcollsurg.2016.05.018","article-title":"Does cancer risk in colonic polyps unsuitable for polypectomy support the need for advanced endoscopic resections?","volume":"223","author":"E Gorgun","year":"2016","journal-title":"J Am Coll Surg"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.gie.2024.04.2905","article-title":"Quality indicators for colonoscopy","volume":"100","author":"DK Rex","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.gie.2017.10.032","article-title":"Volume of surgery for benign colorectal polyps in the last 11 years","volume":"87","author":"MES Bronzwaer","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.1016\/j.cgh.2014.01.026","article-title":"A management algorithm based on delayed bleeding after wide-field endoscopic mucosal resection of large colonic lesions","volume":"12","author":"NG Burgess","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1055\/s-0033-1344987","article-title":"Risk factors for adverse events related to polypectomy in the English Bowel Cancer Screening Programme","volume":"46","author":"MD Rutter","year":"2014","journal-title":"Endoscopy"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"S134","DOI":"10.14309\/01.ajg.0000590432.80477.ec","article-title":"Barriers to endoscopic mucosal resection of large colorectal lesions: results of a nationwide survey. 225","volume":"114","author":"I Holmes","year":"2019","journal-title":"Am J Gastroenterol"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2689-5839.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T23:20:46Z","timestamp":1760656846000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2689-5839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":36,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2025,1,7]]},"published-print":{"date-parts":[[2025]]}},"alternative-id":["a26895839"],"URL":"https:\/\/doi.org\/10.1055\/a-2689-5839","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8,25]]},"published":{"date-parts":[[2025,8,25]]}}}