The purpose of an endoscopic mucosal procedure is to remove precancerous or early-stage cancerous tissues (lesions) from the digestive tract. Gastrointestinal endoscopic mucosal resection (EMR) is a common form of this procedure. EMR is mostly used for treatment, but it can also be used for collecting tissues for diagnosis. In cases of cancer, EMR can help determine whether the cancer has invaded the tissues beneath the digestive tract lining.

A flexible, tube-like tool called an endoscope is used during endoscopic mucosal resection (EMR) to remove gastrointestinal cancers and precancerous lesions.

Electrical snares remove these growths using a thin wire that is fed through the endoscope and tightened around the tumor. By passing an electric current through the wire, the tumor is separated and the wound is cauterized.

EMR is carried out by a gastroenterologist, or a doctor specializing in GI disorders. It allows the doctor to view the inside of the body in high detail thanks to the endoscope. In addition, it can be useful for spotting and removing small growths in the GI tract, including polyps. An upper GI tumor is inserted through the mouth, while a lower GI tumor is inserted through the anus.

During recovery, you will remain in a recovery room until most of the sedative’s effect has worn off. Detailed instructions will be provided about when you can resume normal activities and when you can eat and drink. An endoscopic mucosal resection and laboratory tests performed on lesion samples will likely be discussed with your gastroenterologist in a follow-up appointment. Patients may require oral pain medications or numbing solutions for several days which will be prescribed as necessary.

With the use of an endoscope, a flexible, tube-shaped instrument, endoscopic mucosal resection (EMR) treats gastrointestinal (GI) cancer and precancerous lesions in a minimally invasive manner. Electrical snares are used to remove these growths – a thin wire that forms a loop at the end that tightens around the tumor. The wire separates the tumor and cauterizes the wound by passing electrical current through it.

Gastroenterologists specialize in treating diseases of the gastrointestinal tract, so EMR is performed by them. An endoscope allows the doctor to get a clear view of what is going on inside a patient’s body. The procedure can also detect and remove small growths, such as polyps, from the GI tract. If the tumor is in the upper GI tract, the endoscope will be inserted through the mouth and if it is in the lower GI tract, it will be inserted through the anus.

The advantages and disadvantages of each technique are different. For most precancerous lesions, EMR is relatively simple, uses few devices, and has a long track record of success. Among its disadvantages, this procedure may require additional surgery for some patients. They may have been cured if treated with ESD, however. Moreover, EMR has a high recurrence rate of 15% to 20%, which necessitates further treatment.

ESD has the main advantage of allowing complete dissection of any type of lesion, regardless of the size. It is a basic oncologic principle to remove the entire lesion in one piece, which offers the advantages of accurate histological assessment and staging, curative resection, and a low recurrence rate. The procedure, however, is technically more challenging than EMR and requires advanced endoscopy skills. Additionally, ESD is a relatively complex procedure associated with a higher perforation rate than EMR. It is fortunate that most perforations caused by an ESD can be treated successfully by endoscopy without undergoing surgery.

Endoscopic mucosal procedures are available at Advanced Gastroenterology.

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