Endoscopic mucosal resection (EMR) versus endoscopic submucosal dissection (ESD) for resection of large distal non-pedunculated colorectal adenomas

Abstract

Background: Endoscopic mucosal resection (EMR) is currently the most used technique for resection of large distal colorectal polyps. However, in large lesions EMR can often only be performed in a piecemeal fashion resulting in relatively low radical (R0)-resection rates and high recurrence rates. Endoscopic submucosal dissection (ESD) is a newer procedure that is more difficult resulting in a longer procedural time, but is promising due to the high en-bloc resection rates and the very low recurrence rates. Objective: To investigate whether Endoscopic mucosal resection (EMR) is superior to endoscopic submucosal dissection (ESD) for resection of large distal non-pedunculated colorectal adenomas. Methods: PubMed, Google scholar and Science direct were searched using the following keywords: Endoscopic mucosal resection, endoscopic submucosal dissection and Colorectal adenomas. The authors also screened references from the relevant literature, including all the identified studies and reviews, only the most recent or complete study was included. Documents in a language apart from English have been excluded as sources for interpretation was not found. Papers apart from main scientific studies had been excluded: documents unavailable as total written text, conversation, conference abstract papers and dissertations. Conclusion: EMR is safe and effective for treating colorectal adenomas.