Polypectomy for Large Polyps with Endoscopic Mucosal Resection

Karl Kwok; Tri Tran; Daniel Lew

doi:10.1016/j.giec.2021.12.004

Polypectomy for Large Polyps with Endoscopic Mucosal Resection

Gastrointest Endosc Clin N Am. 2022 Apr;32(2):259-276. doi: 10.1016/j.giec.2021.12.004. Epub 2022 Feb 23.

Authors

Karl Kwok¹, Tri Tran², Daniel Lew³

Affiliations

¹ Interventional Endoscopy, Division of Gastroenterology, Kaiser Permanente, Los Angeles Medical Center, 1526 North Edgemont Street, 7th Floor, Los Angeles, CA 90027, USA. Electronic address: karl.k.kwok@kp.org.
² Department of Medicine, Kaiser Permanente, Los Angeles Medical Center, 4867 W Sunset Boulevard, Los Angeles, CA 90027, USA.
³ Division of Gastroenterology, Cedars Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA.

PMID: 35361335
DOI: 10.1016/j.giec.2021.12.004

Abstract

Beginning in 1955, when the saline injection was first described to prevent transmural injury during polyp fulguration, endoscopic mucosal resection (EMR) has grown exponentially, both in scope and in practice. Because EMR is an organ-preserving technique even for large polyps, this allows for comparable outcomes to surgery, but substantially improved cost savings and significantly reduced morbidity and mortality. To achieve this, however, one must master the 4 fundamental components that are critical to the success of EMR- time, team, tools, and technique. This article aims to provide a compendium of state of the art updates within the field of endoluminal resection.

Keywords: Cap assisted EMR; Cold snare EMR; Comparative effectiveness data; EMR; Endoscopic mucosal resection; Underwater EMR; Wide-field EMR.

Publication types

Review

MeSH terms

Colonic Polyps* / surgery
Endoscopic Mucosal Resection* / methods
Humans