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EMR Explained

Endoscopic Mucosal Resection (EMR) is a minimally invasive procedure used to remove abnormal or precancerous growths, known as lesions, from the digestive tract. 

It is commonly performed in the gastrointestinal (GI) tract, including the esophagus, stomach, and colon. 

During an EMR, an endoscope, a flexible tube with a camera and specialized tools, is inserted through the mouth or anus and carefully advanced to the area of concern. 

The endoscope allows the doctor to visualize the lesion and perform the resection. 

EMR is typically performed under sedation to ensure patient comfort. It offers several advantages, including minimal incisions, faster recovery time, and reduced risk of complications compared to traditional surgical methods. 

EMR is commonly used to remove early-stage cancers, precancerous polyps, or other abnormal growths in the digestive tract. It also allows doctors to obtain tissue samples for further analysis and staging. 

After the procedure, patients may experience mild discomfort or temporary side effects such as bloating or a sore throat. 

Most individuals can resume their normal activities within a few days. 


Benefits

Raising awareness about Endoscopic Mucosal Resection (EMR) and its potential benefits is crucial for several reasons:

Early Detection and Treatment:
By increasing awareness about EMR, individuals and healthcare providers can recognize the importance of early detection and treatment of gastrointestinal abnormalities. 

EMR allows for the removal of precancerous lesions and early-stage cancers, which can greatly improve patient outcomes and increase the chances of a complete cure.

Minimally Invasive Alternative:
EMR offers a less invasive alternative to traditional surgical methods for the removal of abnormal growths in the digestive tract. 

By highlighting the potential benefits of EMR, individuals may feel more comfortable and informed when considering treatment options, ultimately leading to better-informed decisions. 

Reduced Risk and Faster Recovery:
EMR is associated with a reduced risk of complications compared to traditional surgery. By raising awareness about EMR, patients can understand that this minimally invasive procedure often results in shorter hospital stays, faster recovery times, and less post-operative discomfort. 

By raising awareness about EMR, the importance of regular screenings and early intervention can be emphasized, leading to better public health outcomes.

Overall, raising awareness about EMR and its potential benefits is essential to promote early detection, informed decision-making, and improved patient outcomes. 

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Applications of EMR

Endoscopic Mucosal Resection (EMR) can be performed in various areas of the gastrointestinal (GI) tract, depending on the location of the abnormal or precancerous growths. 

Here is a discussion of the different GI areas where EMR can be performed:

  1. Esophagus: EMR can be utilized in the esophagus to remove abnormal growths, such as early-stage esophageal cancer or precancerous lesions called Barrett’s esophagus. It allows for the targeted removal of these lesions while preserving the healthy surrounding tissue.
  2. Stomach: In the stomach, EMR can be employed to remove early-stage gastric cancers or precancerous gastric polyps. It enables the gastroenterologist to precisely resect the abnormal tissue, minimizing the risk of leaving any cancerous cells behind.
  3. Colon: EMR is commonly performed in the colon to remove polyps or abnormal growths. Colon polyps, including adenomas, are considered precursors to colorectal cancer. EMR can effectively remove these polyps during the procedure, reducing the risk of progression to cancer.
  4. Rectum: EMR can be used in the rectum to remove abnormal growths, such as rectal polyps or early-stage rectal cancer. It allows for targeted removal while preserving the functionality of the rectum.

The decision to perform EMR in a particular area is typically based on a thorough evaluation by a gastroenterologist or an endoscopist, considering factors such as the patient’s medical history, overall health, and individual circumstances.


Procedure Explained

Preparing for Endoscopic Mucosal Resection (EMR) involves a few important steps to ensure the procedure goes smoothly and safely.

Here are some common preparations:  

  • Preparation: Before the procedure, the patient is given instructions on how to prepare, which may include dietary restrictions and bowel preparation to ensure the colon or digestive tract is clear.
  • Anesthesia and Sedation: EMR is usually performed under conscious sedation or general anesthesia, depending on the specific case and patient’s needs. This helps ensure patient comfort during the procedure.
  • Insertion of the Endoscope: The gastroenterologist inserts a flexible tube called an endoscope through the mouth or anus, depending on the location being treated. The endoscope has a light and camera on its tip, allowing the doctor to visualize the area of interest.
  • Inspection and Marking: The doctor carefully move the endoscope along the digestive tract, inspecting the lining for any abnormal or suspicious areas. If a lesion is identified, it is marked using various methods, such as tattooing or injection of a dye, to ensure accurate targeting during the resection.
  • Injection and Lift: In some cases, a saline solution or specialized fluid may be injected underneath the lesion. This lifts the lesion from the surrounding tissue, making it easier to remove during the resection.
  • Resection: The gastroenterologist utilizes specialized tools, such as a snare or a cap-assisted device, to remove the lesion. With snare resection, a looped wire snare is placed around the base of the lesion, tightened, and then cut to remove the lesion. With cap-assisted resection, a cap is used to create suction and lift the lesion, allowing for its removal.
  • Hemostasis and Pathology: After the resection, the doctor ensures hemostasis, meaning any bleeding is stopped or controlled. Tissue samples or biopsies may also be taken for further analysis by a pathologist to determine the nature of the lesion and provide a diagnosis.
  • Recovery and Post-Procedure Care: Once the procedure is complete, the patient is taken to a recovery area to gradually awaken from sedation. Post-procedure care instructions are provided, including any dietary restrictions, medication guidelines, and potential side effects to watch for.

It’s important to note that the specific steps may vary depending on the location and complexity of the lesion being treated, as well as the equipment and techniques used by the gastroenterologist. 

The procedure is typically performed by experienced healthcare professionals specialized in endoscopy and gastroenterology.

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Preparation

Preparing for Endoscopic Mucosal Resection (EMR) involves a few important steps to ensure the procedure goes smoothly and safely.

Here are some common preparations:

  1. Consultation and Medical History: You will have an initial consultation with your gastroenterologist to discuss the procedure and your medical history. Be prepared to provide information about any allergies, medications you are currently taking, and any previous surgeries or medical conditions.
  2. Dietary Restrictions: Your doctor will provide specific instructions regarding dietary restrictions prior to the procedure. This typically includes avoiding solid foods for a certain period of time before the procedure and consuming only clear liquids such as water, broth, and juices.
  3. Bowel Preparation: To ensure a clear view of the digestive tract, you may be required to undergo bowel preparation. This involves taking laxatives or a special solution to help cleanse the colon and remove any stool. Your doctor will provide detailed instructions on how to properly prepare, including the timing and dosage of the preparation.
  4. Medication Adjustments: Inform your doctor about any medications you are currently taking, including prescription medications, over-the-counter drugs, and supplements. Some medications may need to be temporarily discontinued or adjusted prior to the procedure, especially blood-thinning medications or those that can interfere with the procedure.
  5. Fasting: You will be instructed to fast for a certain period of time before the procedure. This typically means no food or drink for several hours beforehand to ensure an empty stomach and reduce the risk of complications during sedation.
  6. Transportation: Due to the use of sedation during the procedure, it is important to arrange for someone to accompany you and drive you home afterward. Sedation can impair your judgment and reflexes, making it unsafe to drive or operate machinery.
  7. Clarify Doubts: If you have any questions or concerns about the procedure or the preparation process, make sure to address them with your healthcare provider before the scheduled date.

It is essential to follow the specific instructions provided by your doctor regarding preparation for EMR. Proper preparation helps to ensure the best possible outcome of the procedure and reduces the risk of complications.

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Contact Dr. Deetlefs

Dr Eduan prides himself on his ability to help his patients to the best of his ability by embracing good listening skills, effective communication, compassion, and knowledge, and skill honed during years of private gastroenterology practice.

If you would like to book an appointment with a gastrointestinal (GI) specialist or would simply like more information on a particular GI topic, don’t hesitate to use our online booking form or call Dr. Deetlefs at 021 551 867.  

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

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© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.