Endoscopic Mucosal Resection for Upper Gastrointestinal Neoplasia

Endoscopic mucosal resection (EMR) is an endoscopic technique developed to resect neoplasms confined to the superficial layers of the gastrointestinal (GI) tract. It can be performed for premalignant lesions, early cancer, or subepithelial tumors of the upper GI tract. However, thorough evaluation of the target lesion should precede the procedure. EMR is performed using a snare to resect a lesion after marking and submucosal injection, with various techniques previously introduced to improve the outcome. It can be performed relatively safely, although several complications such as bleeding, perforation, and strictures have been reported. The rate of complete resection for early gastric cancer is reportedly more than 70%; nevertheless, complete resection using the EMR technique is widely dependent on the size of the lesion.