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Selection of EMR and ESD for Laterally Spreading Lesions of the Colon



Colonic laterally spreading lesions (LSL) are increasingly managed using endoscopic methods that comprise two main techniques: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).

Purpose of Review

In this review, we aimed to review the most recent literature on selection of the best endoscopic technique in the management of colonic LSL.

Recent Findings

EMR and ESD are complimentary techniques in the management of patients with colonic LSL.


EMR is safe and effective in most patients with LSL, except for cancers with submucosal invasion in whom R0 resection is favored.

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Endoscopic mucosal resection


Endoscopic submucosal dissection


Granular laterally spreading lesion


Laterally spreading lesion


Non-granular laterally spreading lesion


Submucosa-invasive cancer

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Correspondence to Michael J. Bourke MBBS FRACP.

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Conflict of Interest

Ji Young Bang declares that she has no conflict of interest. Michael Bourke declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Endoscopy

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Bang, J.Y., Bourke, M.J. Selection of EMR and ESD for Laterally Spreading Lesions of the Colon. Curr Treat Options Gastro 16, 376–385 (2018).

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