What is EMR? Let’s draw it!

Many patients at gastroenterology departments or endoscopy centers are recommended for endoscopic mucosal resection (EMR). It’s frequently used, but are you aware of its indications, limitations, and postoperative precautions?

This article will systematically guide you through key EMR information to help you make a more informed and confident decision.

So, what is EMR? Let’s draw it first and see…

❋What do authoritative guidelines say about the indications for EMR? According to the Japanese Gastric Cancer Treatment Guidelines, the Chinese Expert Consensus, and the European Society of Endoscopy (ESGE) guidelines, the currently recommended indications for EMR include the following:

Ⅰ. Benign polyps or adenomas

● Lesions ≤ 20 mm with clear margins

● No obvious signs of submucosal invasion

● Laterally Spreading Tumor (LST-G)

Ⅱ. Focal high-grade intraepithelial neoplasia (HGIN)

● Mucosal-limited, no ulceration

● Lesions smaller than 10 mm

● Well-differentiated

Ⅲ. Mild dysplasia or low-grade lesions with clear pathology and slow growth

◆ Patients deemed suitable for resection after follow-up observation

⚠Note: Although the guidelines state that EMR is acceptable for early-stage cancers if the lesion is small, non-ulcerated, and confined to the mucosa, in actual clinical practice, ESD (endoscopic submucosal dissection) is generally preferred to ensure complete resection, safety, and accurate pathological assessment.

ESD offers several significant advantages:

En bloc resection of the lesion is possible

Facilitates margin assessment, reducing the risk of recurrence

Suitable for larger or more complex lesions

Therefore, EMR is currently primarily used in clinical practice for:

1. Benign lesions with no risk of cancer

2. Small, easily resectable polyps or colorectal LSTs

⚠Postoperative Precautions

1.Dietary Management: For the first 24 hours after surgery, avoid eating or consume clear liquids, then gradually transition to a soft diet. Avoid spicy, astringent, and irritating foods.

2.Medication Use: Proton pump inhibitors (PPIs) are commonly used after surgery for gastric lesions to promote ulcer healing and prevent bleeding.

3.Complication Monitoring: Be alert for postoperative symptoms of bleeding or perforation, such as melena, hematemesis, and abdominal pain. Seek medical attention promptly if any abnormalities occur.

4. Review Plan: Arrange follow-up visits and repeat endoscopies based on pathological findings.

Thus, EMR is an indispensable technique for the resection of gastrointestinal lesions. However, it is crucial to correctly understand its indications and avoid overuse or misuse. For physicians, this requires judgment and skill; for patients, it requires trust and understanding.

Let’s see what we can offer for EMR.

Here are our EMR related endoscopic consumables which include Hemostatic Clips, Polypectomy Snare, Injection Needle and Biopsy Forceps.