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Updated: May 26, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
[Endoscopic mucosal resection of sessile polypoid colorectal lesions: a two-year retrospective study, technique
Pave Markos1, Tomislav Brkić, Roland Pulanić
1Zavod za gastroenterologiju i hepatologiju, Klinika za unutrasnje bolesti Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb.
Introduction:
Endoscopic mucosal resection (EMR) is a therapeutic method for removal of sesile premalignant lesions and intramucosal carcinoma of the gastrointestinal tract. No reports on EMR data in Croatia have been published yet.
Materials And Methods:
All patients included in the study were managed at the University Hospital Centre Zagreb between December 2006 and December 2008. EMR was performed using strip technique with submucosal injection of epinephrine (dilution with saline 1:5000-10000).
Results:
EMR of sessile polypoid colorectal lesions was performed in 95 patients. The most common localisation of the disease was rectum (52 pts - 54.7%). In most patient size of the lesion was between 16-25 mm (43 pts - 45%). En-bloc resection was performed in 75 patients and piecemeal resection in the rest. Bleeding occurred immediately during the EMR in 5 pts (5.3%). Patohistological diagnosis revealed tubulovillous adenoma in 67 pts (70%). Invasive carcinoma was observed in 6 pts (6.3%) and intramucosal carcinoma in 20 pts (21%). On follow up, 73 pts (77%) did not show and sign of disease recurrence. Surgery was needed in 6 pts (6.3%) due to the diagnosis of invasive carcinoma.
Conclusion:
EMR is safe and reliable method with low risk of serious complications and acceptable recurrence rate.
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