How is endoscopic mucosal resection (EMR) used to treat esophageal and gastric cancer?

The EMR procedure is performed with an endoscope—a long, thin, flexible instrument about 1/2 inch in diameter. The endoscope is passed through the patient’s mouth. Through the endoscope, instruments are used to lift the lesion in the lumen (the hollow space) of the gastrointestinal tract, with techniques like injecting fluid underneath the lesion. Afterwards, the lesion is cut out using a snare. The doctor will remove the tumor through the endoscope and out the mouth. EMR has a positive outcome for lesions 2 cm in size or less.

How is the endoscopic mucosal resection (EMR) procedure performed?

The EMR procedure for esophageal or gastric cancer includes the following.

  • The patient is given general anesthesia and sleeps during the procedure.
  • The endoscope is passed through the patient’s mouth.
  • The precancerous or cancerous lesion is identified.
  • The surgeon either injects a liquid into the submucosal layer beneath the lesion or places a rubber band underneath the lesion to lift it and make it easier—and safer—to remove. Use of a rubber band is the most common way to lift a lesion. (The submucosa is the layer of tissue just below the mucous membrane.)
  • The surgeon then captures the lesion with the snare device and cuts the lesion out. The lesion is then grabbed and pulled out of the patient’s mouth with the endoscope.

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