Safety and cost-effectiveness of outpatient colonoscopic polypectomy

Background/Aims: 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. Methodology: 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 multivar-iate logistic regression analysis. Results: 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). Conclusions: Colonoscopic polypectomy can be safely and cost-effectively performed in the outpatient setting with minimal controllable complications.