Safety and cost-effectiveness of outpatient colonoscopic polypectomy.

Abstract

Factors that increase the complications arising from colonoscopic polypectomy have been well studied; however, data regarding complications from outpatient polypectomy is limited. The aim of this study was to identify the safety and costeffectiveness of outpatient colonoscopic polypectomy. Consecutive series of 804 patients who underwent colonoscopic polypectomy for 1,446 polyps were analyzed. Clinical outcomes, complications and medical costs were compared between outpatient (n=731) and planned inpatient groups (n=73) to assess the safety and cost-effectiveness of the colonoscopic polypectomy. The risk factors for polypectomy- related complications were assessed by a multivariate logistic regression analysis. There was no difference in the complication rates between the outpatient polypectomy group (1.1%) and the planned inpatient group (2.7%), and outpatient service was not a significant risk factor of complications in the colonoscopic polypectomy by multivariate analysis. The outcomes of complications were not worsened by outpatient procedures. However, total cost for an outpatient polypectomy for a single polyp without any complication was 37.4% lower than that for a planned inpatient polypectomy, which was a significant reduction (p=0.000). Colonoscopic polypectomy can be safely and cost-effectively performed in the outpatient setting with minimal controllable complications.