The technique and indication of endoscopic mucosal resection and endoscopic submucosal dissection

Accurate endoscopic diagnosis including pit pattern observation is necessary for performing definite endoscopic therapy. Endoscopic mucosal resection (EMR) is performed worldwide for early colorectal cancers 20 mm in diameter. Hyaluronic acid solutions as an injection solution have been used to achieve sustained mucosal elevation, definitive en-bloc resection, and complete resection. In Japan and some other Western and Asian countries, endoscopic submucosal dissection (ESD) is reported to be an efficient treatment with a high rate of en bloc resection for large early colorectal cancers and it is considered less invasive than laparoscopic colectomy. Two knives such as a tip-typed knife and a scissor type are used for safe ESD procedure. In this review, we have demonstrated the efficacies of EMR and ESD for early colorectal cancers.