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Session: ePoster: Other Neoplasia and Endoscopy 2 (Sun1230)

EP453 - Postoperative Outcomes in Adults Undergoing Colorectal Resection For Benign Colorectal Neoplasia: A Retrospective Cohort Study of the ACS-NSQIP 2016-2022

Sunday, May 11, 2025
1:02 PM – 1:07 PM PT
Location: Monitor 7, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • SS

    Sahil Sharma, MD

    Chief Surgical Resident
    McMaster University
    McMaster University
    Hamilton, ON, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Tyler McKechnie, MD MSc (he/him/his)

    Resident Physician
    McMaster University
    McMaster University
    Hamilton, ON, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Kelly Brennan, MD Msc

    General Surgery Resident
    Queen's University
    Queen's University
    Kingston, ON, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • OK

    Olivia Kuszaj, n/a

    Research Assistant
    Division of General Surgery, Department of Surgery, McMaster University
    Hamilton, Ontario, Canada

    Disclosure information not submitted.

  • AD

    Aristithes Doumouras, MD MPH

    General Surgeon
    Associate Professor, Division of General Surgery, McMaster University
    Hamilton, Ontario, Canada

    Disclosure information not submitted.

  • SP

    Sunil V. Patel, MD, MSc, PhD, FRCSC

    Associate Professor
    Queen's University
    Kingston, Ontario, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • NA

    Nalin Amin, MD

    Associate Professor, Surgery
    Division of General Surgery, McMaster University
    Hamilton, Ontario, Canada

    Disclosure information not submitted.

  • DH

    Dennis Hong, MD, MSc

    Associate Professor, Surgery
    Division of General Surgry, McMaster University
    Hamilton, Ontario, Canada

    Disclosure information not submitted.

    • Senior Author(s)

  • Cagla Eskicioglu, MD, MSc (she/her/hers)

    Associate Professor, Surgery
    Division of General Surgery, McMaster University
    Hamilton, ON, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Sahil Sharma, MD: This individual has no financial relationships with ineligible companies.
Tyler McKechnie, MD MSc: This individual has no financial relationships with ineligible companies.
Kelly Brennan, MD Msc: This individual has no financial relationships with ineligible companies.
Sunil V. Patel, MD, MSc, PhD, FRCSC: This individual has no financial relationships with ineligible companies.
Cagla Eskicioglu, MD, MSc: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Colorectal cancer (CRC) screening programs in North America have effectively reduced CRC incidence. Among the nearly six million colonoscopies performed annually in the U.S., 4-11% detect large benign colorectal neoplasms, many of which can be removed endoscopically, minimizing the need for surgery. Endoscopic removal is less invasive, preserves bowel function, and lowers healthcare costs. Despite these benefits, segmental colectomy for benign neoplasia remains common, with surgeries increasing between 2000 and 2014. To address this, efforts have focused on improving access to advanced endoscopic care through training and collaboration initiatives, though their impact on surgery rates is unclear. This study aims to evaluate surgery rates for benign neoplasia using data from the American College of Surgeons (ACS) National Quality Improvement Program (NSQIP) 2016-2022 database.

Methods/Interventions: Adult patients undergoing elective colectomy and/or proctectomy for colorectal neoplasia between 2016 to 2022 were identified in the ACS-NSQIP database utilizing Current Procedure Terminology (CPT) codes and International Classification of Diseases, Tenth Revision (ICD 10) codes. Patients were then classified based on nature of pathology as either benign or malignant. The primary outcome was to determine the frequency of resections per year for benign neoplasia. The secondary outcomes included postoperative 30-day overall morbidity, system-specific complications, and healthcare resource utilization for patients undergoing resections for benign neoplasia. Multivariable regression models were fit to identify variables associated with each secondary outcome.

Results/Outcomes: Overall, 207,250 patients underwent colectomy and/or proctectomy for colorectal neoplasia between 2016 to 2022. Among them 35,108 (17.5%) had resection for benign neoplasia. The proportion of patients undergoing resection for benign neoplasia decreased yearly from 3,458 (22.5%) in 2016 to 2,396 (12.7%) in 2022. Most benign lesions were in the right colon (63.5%), removed during a colectomy with primary anastomosis (91.5%), using a minimally invasive approach (82.8%). The 30-day overall morbidity and mortality was 6.8% and 0.4%, respectively. There were 1114 (3.2%) patients that required a reoperation and 2798 (8.0%) that required a readmission following surgery for benign neoplasia. Patients that were American Society of Anesthesiologists (ASA) class 4 (odds ratio (OR) 2.13, 95% confidence interval (CI) 1.46-3.10), active smokers (OR 1.47,95%CI 1.31-1.63), and those undergoing a proctectomy (OR 1.45,95%CI 1.09-1.93) all had increased odds of postoperative morbidity.

Conclusion/Discussion: Our study of the ACS-NSQIP 2016-2022 database demonstrated a temporal decrease in the proportion of elective colorectal resections for benign neoplasms every year with associated low morbidity and mortality. Identification of patient and treatment factors associated with postoperative morbidity such as ASA class, smoking, and type of operative intervention can help practitioners better counsel patients regarding different management strategies and effectively select patients for the approach most suitable for their presentation.