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Pediatric endoscopic mucosal resection: A 10-year single-center experience.
Brett J Hoskins1, Jared M Grabau2, Douglas K Rex3
1Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Indiana University School of Medicine, Riley Hospital for Children at IU Health, Indianapolis, Indiana, USA.
Journal of Pediatric Gastroenterology and Nutrition
|August 13, 2025
Summary
Endoscopic mucosal resection (EMR) is safe and effective for pediatric gastrointestinal lesions. This study shows EMR is a valuable option for complex pediatric GI conditions, supporting broader adoption with improved training and guidelines.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Minimally Invasive Surgery
Background:
- Endoscopic mucosal resection (EMR) is a standard procedure in adult gastroenterology.
- EMR utilization in pediatric patients is limited by data, training, and equipment availability.
- This study evaluates a decade of pediatric EMR experience at a single center.
Purpose of the Study:
- To assess the feasibility, safety, and efficacy of various EMR techniques in pediatric patients.
- To analyze outcomes of EMR for diverse gastrointestinal lesions in children and adolescents.
- To provide data supporting the expanded use of EMR in pediatric practice.
Main Methods:
- Retrospective review of EMR procedures in patients under 21 years (2015-2025).
- Data collected included patient demographics, lesion characteristics, procedural details, pathology, and outcomes.
- Analysis of conventional hot/cold snare, band-assisted (B-EMR), and underwater EMR (U-EMR) techniques.
Main Results:
- Twenty EMRs were performed in 18 pediatric patients (mean age 17.1 years).
- Lesions included polyposis syndromes, sporadic polyps, and subepithelial lesions, ranging from 6-80 mm.
- Complete resection was achieved in 95% of cases; B-EMR was effective for subepithelial lesions with no delayed complications.
Conclusions:
- EMR is a feasible, safe, and effective therapeutic option for pediatric mucosal and subepithelial gastrointestinal lesions.
- Wider adoption requires enhanced pediatric-specific training, multidisciplinary collaboration, and guideline development.
- EMR represents a valuable tool for managing complex pediatric GI diseases.
