Related Experiment Video
Updated: Aug 11, 2026
Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
Published on: April 28, 2026
Diagnostic use of endoscopic mucosal resection in ''borderline'' gastric lesions unresolved with standard biopsies
D Mazzucco1, I Venturini, E Bollito
1Gastroenterology Unit, ASL 5 Collegno, Turin.
Background:
Endoscopic mucosal resection (EMR) of gastric superficial malignancies less than 20 mm in size and flat or slightly elevated without ulceration can be a definitive treatment, but its role in lesions of uncertain etiology or in which standard biopsies specimens fail to determine diagnosis is uncertain. EMR was performed in 7 patients previously diagnosed as having low grade dysplasia (Category 3 of Vienna classification) by standard biopsies on polypoid or flat gastric lesions.
Methods:
After day spraying with 0.2% indigo carmine and injection of 20 ml saline with adrenaline 1/20000, EMR of flat or sessile polyps (size between 5 to 15 mm) was performed by the Cap and Suction technique (Inoue).
Results:
In 3 patients a previous diagnosis of low grade dysplasia was changed into high grade dysplasia, in 1 patient adenocarcinoma was found at EMR histology. In 3 patients EMR confirmed diagnosis made with routine endoscopy biopsies and finally in 2 patients dysplasia was down-graded into intestinal metaplasia.
Conclusions:
EMR may be considered in diagnostic gastric lesions with low grade dysplasia at standard biopsies (Category 3 of Vienna Classification of gastrointestinal neoplasia).