Endoscopic Mucosal Resection (Emr)

What Is Endoscopic Mucosal Resection (EMR)? How Is EMR Performed?

During routine screening examinations of digestive system organs such as the stomach, esophagus, or large intestine, risky polyps or early-stage cancerous tumors may be detected. Endoscopic Mucosal Resection, or EMR, is the endoscopic removal of risky polyps or early-stage tumors without surgery.

You can find answers in our article to questions such as whether the EMR procedure is risky, whether cancerous tumors are removed with EMR, and how to eat after EMR.

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What Is EMR?

It is a minimally invasive endoscopic procedure used to remove abnormal or early-stage tumor lesions in the mucosal layer of digestive system organs without requiring a surgical incision. No surgical incision is made during the EMR procedure. The procedure is performed by entering through the mouth or anus.

How Is EMR Performed?

• Before Endoscopic Mucosal Resection, or EMR, sedation is administered so that the patient does not feel any pain during the procedure.
• Depending on the area where the procedure will be performed, the endoscope is inserted through the mouth or anus to determine the exact location of the polyp or suspicious tissue to be removed.
• Special contrast agents may also be used during this procedure to provide a clearer view of the suspicious tissue.
• A special fluid is injected beneath the risky tissue to be removed with the EMR procedure. This fluid lifts the risky tissue upward from the muscle layer beneath it. In this way, a safety cushion is created to protect the healthy muscle structure while the risky tissue is removed.
• A special wire snare is passed through the endoscope to capture the lesion to be removed. The suspicious tissue is cut and removed by applying energy to this snare.
• After the tissue is removed, bleeding is checked and the procedure is completed.
• The suspicious lesion is sent to the laboratory for pathological evaluation.

What Are the Advantages of EMR?

• The EMR procedure is performed using an endoscope without making an incision in the body. This means patients do not have any surgical scars.
• One of the biggest advantages of EMR is that it allows early intervention for suspicious lesions. Early diagnosis and treatment of precancerous lesions may also reduce the need for more extensive procedures in the future.
• Because it is an endoscopic procedure, the hospital stay is very short. Patients can return to their social lives the same day or the next day.
• Since it is not a surgical procedure, pain management is much easier.
• Because it does not require general anesthesia, the possible risks of anesthesia are not experienced.
• The risk of infection and bleeding is much lower compared with general surgery.
• It is a life-saving option for patients who have additional illnesses and are not suitable for surgery.

Who Is EMR (Endoscopic Mucosal Resection) Used For?

• Barrett's esophagus: In Barrett's esophagus, which usually develops due to chronic reflux, precancerous changes occur in the lining of the esophagus. EMR can be effectively applied in such cases.
• It can be applied in the early stages of cancers of the esophagus, stomach, or intestines when the cancer is limited to the mucosal layer.
• Precancerous polyps that are especially difficult to remove with standard colonoscopy techniques can be removed with EMR.
• For EMR to be performed, it is important that the suspicious tissue is limited to the mucosal layer. In tumors that deeply invade the organ wall, EMR does not produce successful results.
• EMR can be safely performed in patients who are not suitable for major surgery due to age or underlying health problems.

FREQUENTLY ASKED QUESTIONS ABOUT EMR

How Long Does the EMR Procedure Take?

The duration of the EMR procedure may vary depending on the size, location, and number of suspicious lesions. In general, EMR is an endoscopic procedure that takes 1 to 1.5 hours.

When Can I Return to Work After EMR?

Because EMR is an endoscopic procedure, no surgical incision is made. This allows patients to return to social life very quickly. Patients are discharged the same day or the next day. They can return to work after 2 to 3 days.

Is There a Risk of Recurrence After EMR?

There is a risk of recurrence after Endoscopic Mucosal Resection (EMR). The risk of recurrence is higher, especially after large colorectal polyps that cannot be removed in a single procedure. Still, this rate is around 15%.

Is there an age limit for EMR?

There is no age limit for EMR. On the contrary, it is a safe treatment option for elderly patients and those who are not suitable for surgery.