Polypectomy, Endoscopic Mucosal Resection, and Endoscopic Submucosal Dissection in the Cirrhotic Population

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Endoscopic mucosal resection (EMR) and endoscopic dissection (ESD) are crucial for managing premalignant and early malignant gastrointestinal lesions.
• These endoscopic techniques offer an alternative to invasive surgery, contributing to reduced patient mortality.

Purpose of the Study:

• To review the literature on adverse events associated with EMR and ESD.
• Specifically analyze reported complications in patients with liver cirrhosis.
• Discuss expert opinions on optimizing safety and risk management for these procedures in cirrhotic patients.

Main Methods:

• Comprehensive literature review of reported adverse events.
• Focus on studies involving cirrhotic patients undergoing EMR or ESD.
• Synthesis of expert recommendations for procedural approaches.

Main Results:

• EMR and ESD carry a risk of adverse events, including bleeding and perforation.
• The cirrhotic population may face unique challenges and potentially higher risks during these procedures.
• Specific management strategies and expert insights are crucial for mitigating risks.

Conclusions:

• EMR and ESD are indispensable tools for early gastrointestinal neoplasia management.
• Careful consideration and tailored approaches are necessary when performing these procedures in patients with cirrhosis.
• Further research and consensus on best practices are needed to ensure patient safety.