Endoscopic resection (EMR / ESD)
Removing very early cancers of the oesophagus or stomach from the inside with an endoscope, so the organ is kept intact.
Endoscopic mucosal resection (EMR) for small lesions and endoscopic submucosal dissection (ESD, developed in Japan) for larger en-bloc resections cure mucosal (T1a) cancers and high-grade dysplasia with organ preservation. Standard for Barrett's neoplasia, early squamous cancer, and early gastric cancer meeting Japanese criteria. Radiofrequency ablation eradicates residual Barrett's epithelium. Requires expert endoscopy and careful histologic staging; submucosal invasion (T1b) with risk features needs surgery.
How it works
Submucosal injection lifts the lesion; a snare (EMR) or electrosurgical knife (ESD) resects it en bloc for histologic assessment of depth and margins.
- Organ preservation, low morbidity
- Curative for T1a disease
- Provides definitive staging
- Operator-dependent, long learning curve for ESD
- Not curative for deeper invasion or nodal disease
- Requires endoscopic surveillance afterwards
Latest papers
topQuery for this technology: (TITLE:"Endoscopic resection" OR ABSTRACT:"Endoscopic resection" OR TITLE:"EMR / ESD" OR ABSTRACT:"EMR / ESD") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Endoscopic resection (EMR / ESD), not a curated reading list.