Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View
To discuss the rationale for the widespread application of endoscopic mucosal resection (EMR) rather than endoscopic submucosal dissection (ESD) in Western centers. In Western centers, EMR is the treatment of choice for most non-pedunculated colorectal adenomas >2 cm in size. EMR is sufficiently...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2016-09-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2016-077.pdf |
| _version_ | 1797642696642265088 |
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| author | Ian Holmes Shai Friedland |
| author_facet | Ian Holmes Shai Friedland |
| author_sort | Ian Holmes |
| collection | DOAJ |
| description | To discuss the rationale for the widespread application of endoscopic mucosal resection (EMR) rather than endoscopic submucosal dissection (ESD) in Western centers. In Western centers, EMR is the treatment of choice for most non-pedunculated colorectal adenomas >2 cm in size. EMR is sufficiently effective and safe to be performed without post-procedure hospitalization. Advances in EMR have led to reduced recurrence rates, and recent studies have demonstrated excellent outcomes with endoscopic treatment of recurrent adenomas. While studies from Asia have demonstrated lower recurrence rates with ESD, concern about the higher perforation risk and lengthy procedure time of ESD are two of the barriers preventing widespread adoption of ESD in the West. EMR is likely to continue as the dominant method for the treatment of large colorectal adenomas in Western centers until the limitations of ESD are overcome. |
| first_indexed | 2024-03-11T14:04:00Z |
| format | Article |
| id | doaj.art-2714d0f218ee43d6982b3ad9d82f8d09 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T14:04:00Z |
| publishDate | 2016-09-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-2714d0f218ee43d6982b3ad9d82f8d092023-11-02T02:55:31ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432016-09-0149545445610.5946/ce.2016.0776906Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s ViewIan Holmes0Shai Friedland1 Department of Gastroenterology, Stanford University School of Medicine, Stanford, CA, USA VA Palo Alto Health Care System, Palo Alto, CA, USATo discuss the rationale for the widespread application of endoscopic mucosal resection (EMR) rather than endoscopic submucosal dissection (ESD) in Western centers. In Western centers, EMR is the treatment of choice for most non-pedunculated colorectal adenomas >2 cm in size. EMR is sufficiently effective and safe to be performed without post-procedure hospitalization. Advances in EMR have led to reduced recurrence rates, and recent studies have demonstrated excellent outcomes with endoscopic treatment of recurrent adenomas. While studies from Asia have demonstrated lower recurrence rates with ESD, concern about the higher perforation risk and lengthy procedure time of ESD are two of the barriers preventing widespread adoption of ESD in the West. EMR is likely to continue as the dominant method for the treatment of large colorectal adenomas in Western centers until the limitations of ESD are overcome.http://www.e-ce.org/upload/pdf/ce-2016-077.pdfColonic polypsColonoscopyColorectal neoplasms |
| spellingShingle | Ian Holmes Shai Friedland Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View Clinical Endoscopy Colonic polyps Colonoscopy Colorectal neoplasms |
| title | Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View |
| title_full | Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View |
| title_fullStr | Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View |
| title_full_unstemmed | Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View |
| title_short | Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View |
| title_sort | endoscopic mucosal resection versus endoscopic submucosal dissection for large polyps a western colonoscopist s view |
| topic | Colonic polyps Colonoscopy Colorectal neoplasms |
| url | http://www.e-ce.org/upload/pdf/ce-2016-077.pdf |
| work_keys_str_mv | AT ianholmes endoscopicmucosalresectionversusendoscopicsubmucosaldissectionforlargepolypsawesterncolonoscopistsview AT shaifriedland endoscopicmucosalresectionversusendoscopicsubmucosaldissectionforlargepolypsawesterncolonoscopistsview |