Colorectal endoscopic submucosal dissection is here to stay

Endoscopic mucosal resection (EMR) or mucosectomy and endoscopic submucosal dissection (ESD) are both techniques that have modified the therapeutic outlook of superficial gastrointestinal tract lesions and neoplasms. EMR is used for the en-bloc excision of lesions smaller than 2-3 cm or the piecemeal resection of larger ones. In theory, ESD achieves higher rates of en-bloc resections as compared to EMR with a lower rate of recurrence; however, it shows a higher percentage of complications, particularly in inexperienced centers or in centers at the start of their learning curve.