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Background/Aims <p>Resection of large colon polyps carries a risk of delayed bleeding. This study aimed to evaluate the cost-effectiveness of single- and dual-modality defect closure techniques following conventional hot snare endoscopic mucosal resection (EMR) of large colon polyps.</p> Methods <p>A decision-tree cost-effectiveness analysis was performed from a healthcare payer perspective modeling a 20&#xa0;mm right-sided polyp removed via conventional (hot) EMR. Model inputs were derived from pooled data from 4817 patients. Closure techniques evaluated included through-the-scope clips (TTSC), through-the-scope suturing (TTSS), hemostatic agent (HA), and multimodal combinations.</p> Results <p>TTSC was the most cost-effective strategy (total cost $3842; 17.17 quality-adjusted life-years). HA and multimodal strategies (TTSS + TTSC, TTSC + HA) offered marginally higher effectiveness but at greater cost (HA, $3,932; TTSS + TTSC, $4339.25; TTSC + HA, $4,447.76), resulting in less favorable cost-effectiveness. Sensitivity analyses suggested TTSC remained cost-effective up to a total clip cost of $544.86 and with technical success rates ≥ 67%.</p> Conclusion <p>TTSC provides favorable clinical and economic outcomes, with institutional costs and procedural expertise influencing optimal closure strategy selection.</p>

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Cost-Effectiveness Analysis of Defect Closure Techniques After Conventional Endoscopic Mucosal Resection for Large Colon Polyps

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月27日

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  • Himesh B. Zaver,
  • Jason Erno,
  • Olivia Reszczynski,
  • Owen Battel,
  • Aditya Singh,
  • Gianna Stoleru,
  • Tanya Wanchek,
  • Wendy Novicoff,
  • Ross C. D. Buerlein,
  • Andrew P. Copland

摘要

Background/Aims

Resection of large colon polyps carries a risk of delayed bleeding. This study aimed to evaluate the cost-effectiveness of single- and dual-modality defect closure techniques following conventional hot snare endoscopic mucosal resection (EMR) of large colon polyps.

Methods

A decision-tree cost-effectiveness analysis was performed from a healthcare payer perspective modeling a 20 mm right-sided polyp removed via conventional (hot) EMR. Model inputs were derived from pooled data from 4817 patients. Closure techniques evaluated included through-the-scope clips (TTSC), through-the-scope suturing (TTSS), hemostatic agent (HA), and multimodal combinations.

Results

TTSC was the most cost-effective strategy (total cost $3842; 17.17 quality-adjusted life-years). HA and multimodal strategies (TTSS + TTSC, TTSC + HA) offered marginally higher effectiveness but at greater cost (HA, $3,932; TTSS + TTSC, $4339.25; TTSC + HA, $4,447.76), resulting in less favorable cost-effectiveness. Sensitivity analyses suggested TTSC remained cost-effective up to a total clip cost of $544.86 and with technical success rates ≥ 67%.

Conclusion

TTSC provides favorable clinical and economic outcomes, with institutional costs and procedural expertise influencing optimal closure strategy selection.