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Endoscopic Mucosal Resection (EMR)

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Advanced Colonoscopy and Endoluminal Surgery

Abstract

Endoscopic mucosal resection (EMR) is a minimally invasive alternative for the treatment of various benign, precancerous, and early stage malignant lesions with low risk of lymph node involvement. We review the common indications for its use in the colon and rectum, and provide description of the various EMR techniques, including the novel technique of underwater EMR. Comparison is made between the various submucosal injection solutions available for use during EMR, followed by an overview of the common complications and their management. Finally, clinical outcomes are described and compared to the technique of endoscopic submucosal dissection (ESD).

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Abbreviations

APC:

Argon plasma coagulation

C-EMR:

Cap-assisted EMR

CT:

Computed tomography

DW:

Dextrose water

EMR:

Endoscopic mucosal resection

ESD:

Endoscopic submucosal dissection

EUS:

Endoscopic ultrasound

FM:

Fibrinogen mixture

HA:

Hyaluronic acid

HES:

Hydroxyethyl starch

HPMC:

Hydroxypropyl methylcellulose

HS:

Hypertonic saline

I-EMR:

Injection-assisted EMR

L-EMR:

Ligation-assisted EMR

NS:

Normal saline

PPS:

Postpolypectomy syndrome

U-EMR:

Underwater EMR

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Author information

Authors and Affiliations

  1. Department of Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA

    Husayn Ladhani M.D., Helmi Khadra M.D. & Jeffrey Marks M.D., F.A.C.S., F.A.S.G.E.

Authors
  1. Husayn Ladhani M.D.
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  2. Helmi Khadra M.D.
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  3. Jeffrey Marks M.D., F.A.C.S., F.A.S.G.E.
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Corresponding author

Correspondence to Jeffrey Marks M.D., F.A.C.S., F.A.S.G.E. .

Editor information

Editors and Affiliations

  1. Department of Surgery - Colon and Rectal Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA

    Sang W. Lee

  2. Division of Colon and Rectal Surgery Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA

    Howard M. Ross

  3. Department of Colon and Rectal Surgery Northwell Health, Huntington Hospital Hofstra School of Medicine, Woodbury, New York, USA

    David E. Rivadeneira

  4. Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

    Scott R. Steele

  5. Division of Colorectal Surgery Department of Surgery, Columbia University, New York, New York, USA

    Daniel L. Feingold

Electronic Supplementary Material

Endoscopic resection of a mucosal resection using I-EMR. (MP4 104,221 kb)

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Ladhani, H., Khadra, H., Marks, J. (2017). Endoscopic Mucosal Resection (EMR). In: Lee, S., Ross, H., Rivadeneira, D., Steele, S., Feingold, D. (eds) Advanced Colonoscopy and Endoluminal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-48370-2_15

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  • DOI: https://doi.org/10.1007/978-3-319-48370-2_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48368-9

  • Online ISBN: 978-3-319-48370-2

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