ESD / EMR
Early tumorous changes in the gastrointestinal tract can be removed using minimally invasive endoscopic procedures. They represent an alternative to organ resection. A fundamental distinction is made between endoscopic submucosa dissection (ESD) and endoscopic mucosal resection (EMR). In EMR, the lesion is removed using a snare. For larger areas to be removed, this must be done in several pieces.
This increases the risk of incomplete removal and thus the risk of recurrence. If large lesions are to be ablated in one piece, i.e. en-bloc, an ESD is suitable. The resection is not done with loops, but with special knives. Which method is used initially depends heavily on the respective risk of malignancy.