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Abstract

Endoscopic mucosal resection (EMR) is a safe and effective treatment for large laterally spreading colorectal lesions. The safety and efficacy of EMR follows a key anatomical principle: complete tissue resection of a mucosal lesion above a submucosal fluid cushion to avoid injury to the deeper mural layers. The majority of polyps encountered have low risk of submucosal invasion and are suitably treated by EMR; however, appropriate lesion selection is fundamental to satisfactory patient outcomes. This chapter discusses endoscopic assessment of large colonic polyps, technical aspects of EMR, techniques to manage procedural related complications, and post-procedural follow-up of patients.

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Abbreviations

CAST:

cold forceps avulsion with adjuvant snare-tip soft coagulation

CE:

chromoendoscopy

CRC:

colorectal cancer

CSPEB:

clinically significant post-endoscopic bleeding

DMI:

deep mural injury

EEI:

enhanced endoscopic imaging

EMR:

endoscopic mucosal resection

ESD:

endoscopic submucosal dissection

GIT:

gastrointestinal tract

ICV:

ileocecal valve

LSL:

laterally spreading lesion

MP:

muscularis propria

PPES:

post-polypectomy electrocoagulation syndrome

SMF:

submucosal fibrosis

SMI:

submucosal invasion

STSC:

snare tip soft coagulation

TSC:

topical submucosal chromoendoscopy

TTS:

through the scope

UEMR:

underwater EMR

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Correspondence to Michael J. Bourke .

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Ma, M.X., Bourke, M.J. (2022). Endoscopic Mucosal Resection of Colorectal Lesions. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-56993-8_18

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  • DOI: https://doi.org/10.1007/978-3-030-56993-8_18

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