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EMR and ESD: Indications, techniques and results.

Mamoon Ur Rashid1, Mohammad Alomari1, Sadaf Afraz1

  • 1Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Florida, Weston, FL, 33331, USA.

Surgical Oncology
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PubMed
Summary

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) offer wider resection for early gastrointestinal tumors. This review details their techniques, advantages, and current guidelines for optimal patient outcomes.

Keywords:
Cold EMRColorectal neoplasiaComplicationsEndoscopic mucosal resectionEndoscopic submucosal dissection

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Oncology

Background:

  • Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are advanced endoscopic resection techniques.
  • These methods are employed for treating advanced gastrointestinal lesions, offering improved resection margins over standard polypectomy.
  • EMR and ESD facilitate en bloc removal, crucial for accurate pathological assessment and curative treatment of early neoplastic gastrointestinal lesions.

Purpose of the Study:

  • To provide a comprehensive review of Endoscopic mucosal resection (EMR) and Endoscopic submucosal dissection (ESD) techniques.
  • To discuss the advantages and disadvantages of both EMR and ESD procedures.
  • To cover recent advancements in EMR and ESD techniques and equipment, and to review current guidelines for their application.

Main Methods:

  • Literature review of Endoscopic mucosal resection (EMR) and Endoscopic submucosal dissection (ESD).
  • Discussion of procedural techniques, including advancements and new equipment.
  • Analysis of clinical scenarios and current guideline recommendations for EMR and ESD.

Main Results:

  • EMR and ESD provide wider and deeper resection margins compared to standard polypectomy.
  • En bloc removal of lesions is achievable with EMR and ESD, enabling detailed pathology and curative intent for early neoplastic lesions.
  • Recent advancements have improved the efficacy and applicability of EMR and ESD.

Conclusions:

  • EMR and ESD are valuable endoscopic techniques for managing early neoplastic gastrointestinal lesions.
  • The choice between EMR and ESD depends on lesion characteristics and procedural considerations.
  • Ongoing advancements and guideline adherence are key to optimizing outcomes with these endoscopic resections.