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Endoscopic Mucosal Resection (EMR)

  • Husayn Ladhani
  • Helmi Khadra
  • Jeffrey MarksEmail author
Chapter

Abstract

Endoscopic mucosal resection (EMR) is a minimally invasive alternative for the treatment of various benign, precancerous, and early stage malignant lesions with low risk of lymph node involvement. We review the common indications for its use in the colon and rectum, and provide description of the various EMR techniques, including the novel technique of underwater EMR. Comparison is made between the various submucosal injection solutions available for use during EMR, followed by an overview of the common complications and their management. Finally, clinical outcomes are described and compared to the technique of endoscopic submucosal dissection (ESD).

Keywords

Endoscopic mucosal resection Mucosal lifting agents Mucosal lifting techniques Advanced endoscopic resection Advanced colonoscopy Advanced polypectomy 

Abbreviations

APC

Argon plasma coagulation

C-EMR

Cap-assisted EMR

CT

Computed tomography

DW

Dextrose water

EMR

Endoscopic mucosal resection

ESD

Endoscopic submucosal dissection

EUS

Endoscopic ultrasound

FM

Fibrinogen mixture

HA

Hyaluronic acid

HES

Hydroxyethyl starch

HPMC

Hydroxypropyl methylcellulose

HS

Hypertonic saline

I-EMR

Injection-assisted EMR

L-EMR

Ligation-assisted EMR

NS

Normal saline

PPS

Postpolypectomy syndrome

U-EMR

Underwater EMR

Supplementary material

Video 15.1

Endoscopic resection of a mucosal resection using I-EMR. (MP4 104,221 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of SurgeryUniversity Hospitals Case Medical CenterClevelandUSA

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