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Endoscopic Mucosal Resection (EMR)

Endoscopic mucosal resection is an outpatient procedure, and is performed using an endoscope. An endoscope is a long, flexible, tubular optical instrument, with a light source, used for viewing (and, with attachments, operating on) internal areas of the body.
For the purpose of endoscopic mucosal resection of the upper digestive tract, the endoscope is inserted through the mouth and into the esophagus, stomach, or upper part of the small intestine. If the location of the the procedure is focused on the colon, the endoscope is inserted through the anus. Endoscopic mucosal resection is performed with the patient under deep sedation or general anesthesia. The gastroenterologist performing the procedure will use the camera attached to the endoscope to inspect the lining of the upper gastrointestinal tract.

With an instrument attached to the tip of the endoscope, the gastroenterologist can then suction small nodules or growths and remove this abnormal tissue. The length of the procedure is typically around 25 to 30 minutes. After removal of all abnormal tissues in nearby areas, the tissue can be evaluated by a pathologist.

Some examples of the conditions treated or diagnosed by endoscopic mucosal resection include:

Barrett's esophagus (with high grade dysplasia or superficial esophageal adenocarcinoma)
Cancer of the small intestine (duodenum)
Colon polyps
Colorectal cancer
Esophageal cancer
Noncancerous growths of the uterus (leiomyomas)
Stomach polyps or masses or gastric cancer

EMR is considered to be a very safe procedure. Rare complications, such as bleeding or perforation of the lining of the gastrointestinal tract, can occur, though this has been found to be true in less than 1% of patients receiving the treatment. Common side effects of the procedure can include reaction to the sedative, sore throat, and gassiness, cramps, or bloating. About 20% of patients may experience chest pain following the procedure. Fever, chills, vomiting, black or bright red stool, chest or abdominal pain, and shortness of breath or fainting may indicate a more serious condition and should be immediately reported to your doctor.

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