Endoscopic Mucosal Resection (EMR)
The Center for Minimally Invasive Esophageal Therapies at Boston Medical Center provides compassionate patient care to you and your family using the most advanced and effective medical treatment in New England. We perform innovative and effective procedures, such as endoscopic mucosal resection, and our staff of compassionate diagnosticians, surgeons, physician assistant, nurse practitioners, and surgical nurses collaborate to treat you and guide you on the path to recovery as quickly and comfortably as possible.
Endoscopic mucosal resection, or EMR, is one of the newer, more minimally invasive techniques we offer for patients with esophageal cancer who have small tumors that have not spread outside of the esophagus. It may also be beneficial for patients with Barrett's esophagus. In this simple procedure, we are able to locate, remove and examine cancerous or precancerous lesions of the esophagus. The mucosa is the innermost lining of the esophagus, and it extends down into your gastrointestinal tract. Cancers in this tract often originate in the mucosa, making visualization and access to it essential for diagnosis and treatment.
How to Prepare
Before recommending EMR, your physician will meet with you, take a medical history and perform a physical examination. He or she will review any imaging and order additional tests, if necessary. You may come in for a pre-admission visit to take care of these items and complete paperwork. Please bring with you a list of allergies and the names and dosages of any medications, supplements or herbs you take, and leave valuables at home. Your physician will advise you on any other specific instructions; it is important to follow them carefully. Please also arrange for a ride home following EMR.
What to Expect
Because it is minimally invasive, EMR is generally an outpatient procedure. Unlike traditional surgery, a hospital stay is usually not required, and you can resume normal activities soon after.
Once your throat area is numbed, a needle is inserted and the tumor is injected with a solution to decrease bleeding as well as to create a protective blister so that removal does not damage the rest of your esophagus. Then your physician will insert an endoscope with a cap and a small wire loop at the end. The tumor will be lifted and cut from the mucosa and sucked into the cap as high-frequency electrical energy is applied.
The tissue will be analyzed in the laboratory, and EMR may be repeated if all of the affected tissue is not removed the first time. EMR combined with another treatment method, such as photodynamic therapy, is a common strategy for early-stage esophageal cancer.
After your procedure, you will rest in the recovery room for a few hours. We recommend avoiding strenuous activity for a few days after EMR. You will have a follow-up appointment in the coming weeks. Call us if you notice any redness, swelling, or pain, or have any concerns.