Endoscopic mucosal resection, or EMR, is one of the newer, more minimally invasive techniques we offer for our esophageal cancer patients 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, thus making visualization and access to it essential for diagnosis and treatment.

How to Prepare for EMR

Before recommending EMR, the physician will meet with the patient, take a medical history, and perform a physical examination. He or she will review any imaging and order additional tests, if necessary. The patient may come in for a pre-admission visit to take care of these items and complete paperwork. Patients should bring a list of allergies and names and dosages of any medications, supplements, or herbs that they take, and leave their valuables at home. It is important to follow any other specific instructions carefully, and also arrange for a ride home following EMR.

What to Expect During EMR

Due to its minimally invasive nature, EMR is generally an outpatient procedure. Unlike traditional surgery, a hospital stay is usually not required, and patients can resume normal activities soon after.

Once the 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 the esophagus. Then the physician inserts an endoscope, a small, flexible, lighted tube, 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 can 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.

Recovery from EMR

After the procedure, patients rest in the recovery room for a few hours. They should avoid strenuous activity for a few days after EMR. They will have a follow-up appointment in the coming weeks. Patients should call the Center if they notice any redness, swelling, or pain, or have any concerns.