Contents

Description

Overview

Endoscopic mucosal resection (EMR) and submucosal dissection (ESD) are advanced endoscopic techniques used to treat early gastrointestinal cancer, large polyps, or submucosal tumors. These techniques allow for complete removal of tumors while preserving the organ, with advantages over traditional surgery including no external incision, faster recovery, and improved long-term quality of life. The five-year efficacy for early cancer treatment is similar to surgery.

Features

Summary

EMR/ESD is an endoscopic alternative to surgical resection of mucosal and submucosal neoplastic lesions and intramucosal cancers. EMR/ESD offers both diagnostic and therapeutic capability. Lesions limited to the mucosa and the superficial layers of the submucosa appear to be the most amenable to endoscopic cure.

Procedure

EMR refers to the local mucosal resection performed under endoscopy for patients with superficial mucosal lesions of the gastrointestinal wall. EMR is suitable for smaller and regular-shaped gastrointestinal tumors (<2-3 cm), with advantages of shorter treatment time, lower cost, and higher safety. However, it is not suitable for larger tumors or those with fibrosis, and the local tumor recurrence rate after surgery is higher. Physiological saline is injected into the submucosal layer to move the mucosal lesion away from the muscle layer, and then a circular cutter is used to remove the lesion. Another method is using the cap-assisted EMR-C, which inflates the lesion and then removes it by suctioning it into the cap before cutting it.

Compared to EMR, ESD can handle larger lesions. First, the lesion is delineated by staining, and then a needle is injected into the submucosal layer to create a space to facilitate dissection with a snare or knife. ESD is suitable for larger tumors or those with fibrosis, with advantages of a higher complete removal rate and lower local tumor recurrence rate. However, treatment time is longer, cost is higher, and complications are higher.

Notification

Possible side effects may include: temporary reactions to preparatory medications (such as dry mouth, blurred vision, palpitations, difficulty urinating, and difficulty swallowing), or fever, chills, nausea, vomiting, dark or bloody stools, chest or abdominal pain, difficulty breathing, and dizziness.

Possible complications may include:

1. Gastrointestinal bleeding: Occurs in about 5.5% of cases and can lead to hemorrhagic shock in severe cases.
2. Gastrointestinal tract perforation: Occurs in about 1.2-6% of cases.
3. Esophageal stenosis: Mainly occurs after excision of esophageal lesions, with an incidence rate of about 2-26%.
4. Mediastinal emphysema, subcutaneous emphysema, pneumothorax: Mainly occurs during excision of esophageal lesions, with an incidence rate of up to 7%.

Estimated Cost

For estimated medical costs, please contact International Medical Services Center.