Endoscopic Mucosal Resection (EMR) Procedure Q&A

An endoscopic mucosal resection (EMR) is a procedure to remove precancerous, early-stage cancerous tissues (lesions) from the digestive tract.

Mucosal resection is performed using an endoscopic device that consists of a long, narrow tube that has a light, a video camera, and other instruments. The endoscope is passed down the throat to find abnormalities in the esophagus, stomach, or upper portion of the small intestine (duodenum) during EMR of the upper digestive tract. Through the anus, the tube is guided up to remove lesions from the colon.

EMR is primarily used for treating patients, but it can also be used to collect tissues for diagnosis. EMR can determine whether cancer has invaded tissues beneath the digestive tract lining if cancer is present.

To identify the abnormality, the physician uses an endoscope, a flexible tube with a light source, and a camera. Endoscopes are inserted through the mouth or rectum. An intravenous (IV) line will be started before the procedure begins to administer sedatives or anesthesia. The position you will be in is lying on your left side. Before, during, and after the procedure, your oxygen level, blood pressure, and pulse will be monitored continuously. A spray is used to numb your throat for upper endoscopies.

To raise and buffer the lesion, a solution will be injected under and around the lesion once the endoscope is advanced to the lesion. Using various tools, the doctor will remove the tissue from the lesion and send it to the laboratory for testing. The procedure usually takes about 1-2 hours, but expect your visit to last an additional two to three hours to allow for pre-procedure preparation and follow-up.

For the removal of abnormal tissues from the lining of the digestive tract, endoscopic mucosal resection is a less invasive option than surgery. Precancerous lesions or early stages of cancer may be present in these tissues.

An expert in digestive system disorders (gastroenterologist) usually performs endoscopic mucosal resections.

It will take some time for the sedative to wear off, so you’ll remain in a recovery room until it does. You will receive written instructions on when you can resume normal activities and start eating and drinking.

Within 24 hours after the procedure, relatively mild side effects may occur, including reactions to the sedative. Drowsiness, nausea, and vomiting may continue to occur. Having a sore throat. Your throat may be sore if the endoscope was guided down your esophagus. You may feel gassy or crampy. After the procedure, you may experience gas, bloating, or cramps if air was pumped into your digestive system.

After receiving written instructions, you will know when to contact your doctor or seek emergency medical attention. A serious complication from endoscopic mucosal resection may cause fever, vomiting, chills, black stool, shortness of breath, fainting, bright red blood in the stool, or chest or abdominal pain.

Your gastroenterologist will likely schedule a follow-up appointment to discuss the results of your endoscopic mucosal resection and laboratory tests.

Three to twelve months after your procedure, you will have a follow-up exam to make sure the entire lesion has been removed. Your doctor will advise you about further testing based on the results. A visual inspection with an endoscope is likely to be part of the exam. A doctor may tattoo the area of the removed lesion so that when a follow-up endoscopy is performed, he or she can be sure the lesion has been completely removed.

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