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EMR Versus ESD: Pros and Cons

  • Fayez Sarkis
  • Vijay Kanakadandi
  • Mojtaba S. Olyaee
  • Amit RastogiEmail author
Chapter

Abstract

The two techniques for removal of large colonic polyps are endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). While EMR is easier to learn and perform, has a lower risk of adverse events, and carries a lower-cost burden, ESD is associated with lower risk of recurrence and may obviate the need for surgery in a subset of lesions with early invasive cancer. However, Western endoscopists have limited experience with ESD, and there is no reimbursement for this procedure in the USA. Therefore, there is limited incentive to learn and perform this more complex and higher-risk procedure by Western endoscopists. EMR therefore continues to be the more commonly performed endoscopic resection procedure. Here we discuss the advantages and disadvantages of the EMR vs. ESD and their role in the management of large colon polyps. Furthermore, we also discuss the pros and cons of ESD versus EMR in early squamous esophageal cancer, early Barrett’s-related esophageal cancer, and early gastric cancer.

Keywords

Adenoma Endoscopic mucosal resection Endoscopic submucosal dissection R0 resection Colonoscopy Advanced adenoma, Barrett’s esophagus, Squamous cell cancer, Gastric cancer 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Fayez Sarkis
    • 1
  • Vijay Kanakadandi
    • 1
  • Mojtaba S. Olyaee
    • 1
  • Amit Rastogi
    • 1
    Email author
  1. 1.Department of Gastroenterology and HepatologyThe University of Kansas HospitalKansas CityUSA

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