Trends in Colectomies for Colorectal Neoplasms in Ulcerative Colitis: a National Inpatient Sample Database Analysis over Two Decades.


Journal

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: United States
ID NLM: 9706084

Informations de publication

Date de publication:
08 2020
Historique:
received: 04 07 2019
accepted: 25 05 2020
pubmed: 20 6 2020
medline: 15 4 2021
entrez: 20 6 2020
Statut: ppublish

Résumé

Rates of colectomy for ulcerative colitis have been decreasing, particularly since the advent of biologics, but the subsequent impact of reduced colectomy rates on the development of neoplasms in chronically treated ulcerative colitis colons is unknown. To determine trends in colectomy for colorectal neoplasms in adult patients with ulcerative colitis. Adult admissions with ulcerative colitis were identified from the National Inpatient Sample from 1993 to 2015. The rate of colectomy with concurrent colorectal neoplasm served as the primary outcome and was evaluated using time trend linear and multivariable regression. There were 366,286 admissions with ulcerative colitis including 16,556 (4.5%) total colectomies. Of those undergoing colectomy, 2018 (12.2%) had a concurrent diagnosis of colorectal neoplasm. The proportion of colectomies for ulcerative colitis with concurrent colorectal neoplasm increased from 10.3 to 12.5% (p Operative management of ulcerative colitis appears to be slowly increasing in oncological indications. The rising proportions of colectomies performed for colorectal neoplasms suggest the need for continued screening in these patients, including rectal surveillance.

Sections du résumé

BACKGROUND
Rates of colectomy for ulcerative colitis have been decreasing, particularly since the advent of biologics, but the subsequent impact of reduced colectomy rates on the development of neoplasms in chronically treated ulcerative colitis colons is unknown.
PURPOSE
To determine trends in colectomy for colorectal neoplasms in adult patients with ulcerative colitis.
METHODS
Adult admissions with ulcerative colitis were identified from the National Inpatient Sample from 1993 to 2015. The rate of colectomy with concurrent colorectal neoplasm served as the primary outcome and was evaluated using time trend linear and multivariable regression.
RESULTS
There were 366,286 admissions with ulcerative colitis including 16,556 (4.5%) total colectomies. Of those undergoing colectomy, 2018 (12.2%) had a concurrent diagnosis of colorectal neoplasm. The proportion of colectomies for ulcerative colitis with concurrent colorectal neoplasm increased from 10.3 to 12.5% (p
DISCUSSION
Operative management of ulcerative colitis appears to be slowly increasing in oncological indications. The rising proportions of colectomies performed for colorectal neoplasms suggest the need for continued screening in these patients, including rectal surveillance.

Identifiants

pubmed: 32557016
doi: 10.1007/s11605-020-04666-8
pii: 10.1007/s11605-020-04666-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1721-1728

Auteurs

Alexander Ni (A)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Mohammed Al-Qahtani (M)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Ebram Salama (E)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Daniel Marinescu (D)

Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Maria Abou Khalil (MA)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Julio Faria (J)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Nancy Morin (N)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Gabriela Ghitulescu (G)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Carol-Ann Vasilevsky (CA)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada.

Marylise Boutros (M)

Faculty of Medicine, McGill University, Montreal, Quebec, Canada. marylise.boutros@mcgill.ca.
Division of Colon and Rectal Surgery, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Suite G317, Montreal, H3T 1E2, Quebec, Canada. marylise.boutros@mcgill.ca.

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