A prospective case controlled study of the short-term outcome following hemicolectomy for benign compared with malignant colonic polyps

Aim The number of patients diagnosed with advanced colonic polyps has increased due to screening. The outcome of hemicolectomy for benign lesions is poorly documented. We present a case‐matched study comparing the results of hemicolectomy for benign and malignant polyps performed in two institutions...

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Veröffentlicht in:Colorectal disease 2014-03, Vol.16 (3), p.179-185
Hauptverfasser: Brigic, A., Cahill, R. A., Bassett, P., Clark, S. K., Kennedy, R. H.
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container_end_page 185
container_issue 3
container_start_page 179
container_title Colorectal disease
container_volume 16
creator Brigic, A.
Cahill, R. A.
Bassett, P.
Clark, S. K.
Kennedy, R. H.
description Aim The number of patients diagnosed with advanced colonic polyps has increased due to screening. The outcome of hemicolectomy for benign lesions is poorly documented. We present a case‐matched study comparing the results of hemicolectomy for benign and malignant polyps performed in two institutions. Methods Data for consecutive patients undergoing surgery for benign colonic polyps (BCPs) were prospectively collected in two hospitals. Each patient was matched for age, sex, ASA grade, site and type of resection (laparoscopic, open and converted) with two controls who underwent surgery for colon cancer (CC). The length of stay (LOS) and 30‐day outcome were analysed adjusting for potential confounders. Multilevel linear and logistic regression analyses were performed. Results Forty‐six patients having hemicolectomy for BCP were matched with 81 patients with CC. The median size of BCP was 4 cm [interquartile range (IQR) 2.5–5.4 cm]. Patients with a BCP had a marginally longer LOS [median 5.5 (IQR 4–8) days and 5 (IQR 3–7) days (P = 0.04)]. Twenty‐one (46%) of 46 patients with BCP had a postoperative complication compared with 25 (31%) of 81 CC patients (P = 0.12, OR = 2.11, 95% CI 0.82–5.41). Four (9%) of 46 patients with BCP underwent re‐operation and a further three (7%) were readmitted compared with one (1%) and two (2%) of 81 patients with CC (P = 0.07 and 0.28). There was no mortality in either group. Conclusion Complications following hemicolectomy for BCP or CC are not significantly different. The results of the study provide further impetus to develop local full thickness colonic excision for benign colonic lesions as an alternative to major surgery.
doi_str_mv 10.1111/codi.12468
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A. ; Bassett, P. ; Clark, S. K. ; Kennedy, R. H.</creator><creatorcontrib>Brigic, A. ; Cahill, R. A. ; Bassett, P. ; Clark, S. K. ; Kennedy, R. H.</creatorcontrib><description>Aim The number of patients diagnosed with advanced colonic polyps has increased due to screening. The outcome of hemicolectomy for benign lesions is poorly documented. We present a case‐matched study comparing the results of hemicolectomy for benign and malignant polyps performed in two institutions. Methods Data for consecutive patients undergoing surgery for benign colonic polyps (BCPs) were prospectively collected in two hospitals. Each patient was matched for age, sex, ASA grade, site and type of resection (laparoscopic, open and converted) with two controls who underwent surgery for colon cancer (CC). The length of stay (LOS) and 30‐day outcome were analysed adjusting for potential confounders. Multilevel linear and logistic regression analyses were performed. Results Forty‐six patients having hemicolectomy for BCP were matched with 81 patients with CC. The median size of BCP was 4 cm [interquartile range (IQR) 2.5–5.4 cm]. Patients with a BCP had a marginally longer LOS [median 5.5 (IQR 4–8) days and 5 (IQR 3–7) days (P = 0.04)]. Twenty‐one (46%) of 46 patients with BCP had a postoperative complication compared with 25 (31%) of 81 CC patients (P = 0.12, OR = 2.11, 95% CI 0.82–5.41). Four (9%) of 46 patients with BCP underwent re‐operation and a further three (7%) were readmitted compared with one (1%) and two (2%) of 81 patients with CC (P = 0.07 and 0.28). There was no mortality in either group. Conclusion Complications following hemicolectomy for BCP or CC are not significantly different. The results of the study provide further impetus to develop local full thickness colonic excision for benign colonic lesions as an alternative to major surgery.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.12468</identifier><identifier>PMID: 24164785</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adenoma - surgery ; Aged ; Benign ; Carcinoma - surgery ; Case-Control Studies ; Cohort Studies ; Colectomy - methods ; colon ; Colonic Neoplasms - surgery ; Colonic Polyps - surgery ; Female ; Humans ; Length of Stay ; Linear Models ; Logistic Models ; Male ; Middle Aged ; Multilevel Analysis ; outcomes ; polyp ; Postoperative Complications ; Prospective Studies ; surgery ; Treatment Outcome</subject><ispartof>Colorectal disease, 2014-03, Vol.16 (3), p.179-185</ispartof><rights>Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland</rights><rights>Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3678-fdc9e8fae3f913fa635c20ab5846f3001a3b013b04f83caf88eb2ccab9a7f3673</citedby><cites>FETCH-LOGICAL-c3678-fdc9e8fae3f913fa635c20ab5846f3001a3b013b04f83caf88eb2ccab9a7f3673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcodi.12468$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcodi.12468$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24164785$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brigic, A.</creatorcontrib><creatorcontrib>Cahill, R. A.</creatorcontrib><creatorcontrib>Bassett, P.</creatorcontrib><creatorcontrib>Clark, S. K.</creatorcontrib><creatorcontrib>Kennedy, R. H.</creatorcontrib><title>A prospective case controlled study of the short-term outcome following hemicolectomy for benign compared with malignant colonic polyps</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim The number of patients diagnosed with advanced colonic polyps has increased due to screening. The outcome of hemicolectomy for benign lesions is poorly documented. We present a case‐matched study comparing the results of hemicolectomy for benign and malignant polyps performed in two institutions. Methods Data for consecutive patients undergoing surgery for benign colonic polyps (BCPs) were prospectively collected in two hospitals. Each patient was matched for age, sex, ASA grade, site and type of resection (laparoscopic, open and converted) with two controls who underwent surgery for colon cancer (CC). The length of stay (LOS) and 30‐day outcome were analysed adjusting for potential confounders. Multilevel linear and logistic regression analyses were performed. Results Forty‐six patients having hemicolectomy for BCP were matched with 81 patients with CC. The median size of BCP was 4 cm [interquartile range (IQR) 2.5–5.4 cm]. Patients with a BCP had a marginally longer LOS [median 5.5 (IQR 4–8) days and 5 (IQR 3–7) days (P = 0.04)]. Twenty‐one (46%) of 46 patients with BCP had a postoperative complication compared with 25 (31%) of 81 CC patients (P = 0.12, OR = 2.11, 95% CI 0.82–5.41). Four (9%) of 46 patients with BCP underwent re‐operation and a further three (7%) were readmitted compared with one (1%) and two (2%) of 81 patients with CC (P = 0.07 and 0.28). There was no mortality in either group. Conclusion Complications following hemicolectomy for BCP or CC are not significantly different. The results of the study provide further impetus to develop local full thickness colonic excision for benign colonic lesions as an alternative to major surgery.</description><subject>Adenoma - surgery</subject><subject>Aged</subject><subject>Benign</subject><subject>Carcinoma - surgery</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>Colectomy - methods</subject><subject>colon</subject><subject>Colonic Neoplasms - surgery</subject><subject>Colonic Polyps - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Linear Models</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multilevel Analysis</subject><subject>outcomes</subject><subject>polyp</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>surgery</subject><subject>Treatment Outcome</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9u1DAQhyMEon_gwgMgHxFSShx7E-dY7UIpqqiQQHCzHGfcNdhxsB2WPEFfm9lu2yOW7LFG33zS_IriFa3OKJ53Ogz2jNa8EU-KY8obVlJGxdO7f12KjlZHxUlKP6uKNi0Vz4ujmtOGt2J1XNyekymGNIHO9g8QrRI-YcwxOAcDSXkeFhIMyVsgaRtiLjNET8KcdfBADGJhZ8cbsgVvdXDoCX7BfiQ9jPZmRJufVETXzuYt8cphU40Z-y6MVpMpuGVKL4pnRrkEL-_rafHtw_uv64_l1fXF5fr8qtSsaUVpBt2BMAqY6SgzqmErXVeqXwneGIYLKtZXFC83gmllhIC-1lr1nWoNGthp8ebgxa1_z5Cy9DZpcE6NEOYkKe-6fYRdh-jbA6oxoBTByClar-IiaSX3wct98PIueIRf33vn3sPwiD4kjQA9ADvrYPmPSq6vN5cP0vIwY1OGv48zKv6SuEq7kt8_X0i-_iH4l80nuWH_AIEQoRg</recordid><startdate>201403</startdate><enddate>201403</enddate><creator>Brigic, A.</creator><creator>Cahill, R. A.</creator><creator>Bassett, P.</creator><creator>Clark, S. K.</creator><creator>Kennedy, R. H.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201403</creationdate><title>A prospective case controlled study of the short-term outcome following hemicolectomy for benign compared with malignant colonic polyps</title><author>Brigic, A. ; Cahill, R. A. ; Bassett, P. ; Clark, S. K. ; Kennedy, R. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3678-fdc9e8fae3f913fa635c20ab5846f3001a3b013b04f83caf88eb2ccab9a7f3673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adenoma - surgery</topic><topic>Aged</topic><topic>Benign</topic><topic>Carcinoma - surgery</topic><topic>Case-Control Studies</topic><topic>Cohort Studies</topic><topic>Colectomy - methods</topic><topic>colon</topic><topic>Colonic Neoplasms - surgery</topic><topic>Colonic Polyps - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Linear Models</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multilevel Analysis</topic><topic>outcomes</topic><topic>polyp</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brigic, A.</creatorcontrib><creatorcontrib>Cahill, R. A.</creatorcontrib><creatorcontrib>Bassett, P.</creatorcontrib><creatorcontrib>Clark, S. K.</creatorcontrib><creatorcontrib>Kennedy, R. H.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brigic, A.</au><au>Cahill, R. A.</au><au>Bassett, P.</au><au>Clark, S. K.</au><au>Kennedy, R. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective case controlled study of the short-term outcome following hemicolectomy for benign compared with malignant colonic polyps</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2014-03</date><risdate>2014</risdate><volume>16</volume><issue>3</issue><spage>179</spage><epage>185</epage><pages>179-185</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim The number of patients diagnosed with advanced colonic polyps has increased due to screening. The outcome of hemicolectomy for benign lesions is poorly documented. We present a case‐matched study comparing the results of hemicolectomy for benign and malignant polyps performed in two institutions. Methods Data for consecutive patients undergoing surgery for benign colonic polyps (BCPs) were prospectively collected in two hospitals. Each patient was matched for age, sex, ASA grade, site and type of resection (laparoscopic, open and converted) with two controls who underwent surgery for colon cancer (CC). The length of stay (LOS) and 30‐day outcome were analysed adjusting for potential confounders. Multilevel linear and logistic regression analyses were performed. Results Forty‐six patients having hemicolectomy for BCP were matched with 81 patients with CC. The median size of BCP was 4 cm [interquartile range (IQR) 2.5–5.4 cm]. Patients with a BCP had a marginally longer LOS [median 5.5 (IQR 4–8) days and 5 (IQR 3–7) days (P = 0.04)]. Twenty‐one (46%) of 46 patients with BCP had a postoperative complication compared with 25 (31%) of 81 CC patients (P = 0.12, OR = 2.11, 95% CI 0.82–5.41). Four (9%) of 46 patients with BCP underwent re‐operation and a further three (7%) were readmitted compared with one (1%) and two (2%) of 81 patients with CC (P = 0.07 and 0.28). There was no mortality in either group. Conclusion Complications following hemicolectomy for BCP or CC are not significantly different. The results of the study provide further impetus to develop local full thickness colonic excision for benign colonic lesions as an alternative to major surgery.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>24164785</pmid><doi>10.1111/codi.12468</doi><tpages>7</tpages></addata></record>
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subjects Adenoma - surgery
Aged
Benign
Carcinoma - surgery
Case-Control Studies
Cohort Studies
Colectomy - methods
colon
Colonic Neoplasms - surgery
Colonic Polyps - surgery
Female
Humans
Length of Stay
Linear Models
Logistic Models
Male
Middle Aged
Multilevel Analysis
outcomes
polyp
Postoperative Complications
Prospective Studies
surgery
Treatment Outcome
title A prospective case controlled study of the short-term outcome following hemicolectomy for benign compared with malignant colonic polyps
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