Endoscopic Mucosal Resection
What is Endoscopic Mucosal Resection?
Endoscopic mucosal resection, commonly referred to as EMR, is a medical procedure performed on patients who have been diagnosed with cancer of the gastrointestinal (GI) tract and who need malignant tissue removed or on very large or flat polyps that cannot be removed by conventional means. EMR is less invasive than traditional surgery. Primarily an endoscopy treatment, the procedure requires the use of a very long, thin endoscope with a light, camera and other devices attached to its tip. The endoscope can be used as a surgical tool as well as a device to perform biopsy, in order to collect tissue samples and check whether cancer has spread deep beneath the lining of the digestive tract.
The patient is sedated during the entire endoscopic mucosal resection procedure. The performing endoscopist, usually a gastroenterologist or GI doctor, will guide the endoscope either down a patient’s throat or up the patient’s colon until it reaches the location of the cancerous lesion or tumor that needs to be removed. Insertion through the mouth occurs when a lesion has been found in the upper GI tract (the esophagus, the stomach and the uppermost portion of the small intestine known as the duodenum). Conversely, insertion of the endoscope through the anus is required if the cancerous tissue resides in the large intestine, or colon.
What Are the Risks of EMR?
Risks of endoscopic mucosal resection are in line with the risks of any other endoscopic procedure. Although occurrences are rare, some patients do experience bleeding and perforation (tearing) after the procedure is over. By far, the most dangerous of these risks is tearing, which usually requires surgery to repair and can sometimes result in death. Gastrointestinal bleeding, on the other hand, is more common and is usually identified when the patient notices blood in his or her stool after the EMR procedure.
Another reported after effect is tract narrowing (obstruction), which happens when scarring causes the esophagus or colon to narrow, which, in turn, can result in digestive problems. The risk of narrowing or obstruction is quite low, but occurs more in procedures where the cancerous lesion is large and surrounds the nearly the entire circumference of a person’s GI tract. Contact a gastroenterologist immediately if you are recovering from endoscopic mucosal resection surgery and notice blood in your stool, black-colored stool, chills, fever, chest or abdominal pain or fatigue.
Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014