Related Experiment Video
Updated: Nov 11, 2025
08:26
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
920
Cold versus hot endoscopic mucosal resection for large sessile colon polyps: a cost-effectiveness analysis
Dhairya Mehta1,2,3, Adam H Loutfy1, Vladimir M Kushnir4
1Department of Medicine, University Hospitals, Cleveland, Ohio, USA.
Endoscopy
|March 30, 2021
Summary
Cold endoscopic mucosal resection (EMR) is more cost-effective than hot EMR for large sessile colorectal polyps. This method offers lower costs and fewer lost workdays, potentially saving Medicare millions annually.
Area of Science:
- Gastroenterology
- Health Economics
- Medical Technology Assessment
Background:
- Large sessile colorectal polyps (LSCPs) pose treatment challenges.
- Cold endoscopic mucosal resection (EMR) offers safety benefits over hot EMR.
- Concerns exist regarding potentially higher recurrence rates with cold EMR.
Purpose of the Study:
- To conduct a cost-effectiveness analysis comparing cold EMR and hot EMR for LSCPs.
- To evaluate the economic implications of adopting cold EMR for LSCP treatment.
Main Methods:
- A decision analysis model was developed for LSCP EMR.
- The model incorporated EMR technique, clip use, mortality, adverse events, and recurrence.
- Data on adverse events and recurrence were sourced from recent literature, prioritizing systematic reviews and RCTs.
Main Results:
- Cold EMR averaged $5213 per procedure versus $6168 for hot EMR over 30 months, a $955 cost saving.
- Lost productivity days were similar: 6.2 for cold EMR and 6.3 for hot EMR.
- Cost advantage of cold EMR persisted across sensitivity analyses; clip cost had the largest impact on marginal cost.
Conclusions:
- Cold EMR is the dominant strategy for LSCPs, demonstrating superior cost-effectiveness and reduced productivity loss.
- Transitioning to cold EMR for LSCPs in the US could yield substantial annual savings for Medicare beneficiaries.
More Related Videos
Related Concept Videos
01:25Endoscopic Procedures II: Colonoscopy
325
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
325
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
271
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
271