Endoscopic mucosal resection (EMR) of the digestive tract is a treatment for removing precancerous, early-stage cancer, or other diseased tissues (lesions).
A long, thin tube containing a light, video camera, and other tools are used to do endoscopic mucosal excision. The tube (endoscope) is inserted down your neck during EMR of the upper digestive system to reach an abnormality in your esophagus, stomach, or upper section of the small intestine (duodenum).
The tube is directed up via the anus to remove lesions from the colon. EMR is primarily a therapeutic method, but it can also be used to harvest tissues for diagnostic purposes. If cancer is present, EMR can assist in determining if it can be treated.
Endoscopic mucosal excision is a less invasive procedure for removing aberrant tissues from the digestive tract’s lining.
Here are some important tips to remember when undergoing EMR for removing cancer tissues:
- Choose an experienced endoscopist: EMR is a specialized procedure that requires skill and expertise. It is crucial to seek an experienced endoscopist who has performed a significant number of EMR procedures. They will have the necessary knowledge and proficiency to perform the resection safely and effectively.
- Pre-procedure evaluation: Before the EMR, you will likely undergo a thorough evaluation that may include imaging tests, such as endoscopic ultrasound or computed tomography (CT) scan. This evaluation helps determine the size, location, and depth of the cancerous tissues and guides the endoscopist in planning the resection.
- Understand the risks and benefits: It’s important to have a clear understanding of the risks and benefits associated with EMR. Discuss these with your healthcare provider to make an informed decision about the procedure. While EMR is generally considered safe, potential risks include bleeding, infection, perforation of the gastrointestinal tract, or the possibility of incomplete removal of cancerous tissues.
- Follow preparation instructions: Your healthcare provider will provide specific instructions to prepare for the EMR procedure. This may include dietary restrictions, fasting, or bowel preparation to ensure optimal visualization during the procedure. It is crucial to follow these instructions carefully to increase the chances of a successful and safe EMR.
- Sedation or anesthesia: EMR is typically performed under sedation or anesthesia to ensure your comfort and minimize discomfort during the procedure. Discuss the options with your healthcare provider and understand the type of sedation or anesthesia that will be used.
- Post-procedure care: After the EMR, your healthcare provider will provide instructions for post-procedure care. This may include dietary restrictions, medication management, and monitoring for any signs of complications, such as bleeding or infection. Follow these instructions diligently to promote proper healing and reduce the risk of complications.
- Regular follow-up: After the EMR, regular follow-up appointments will be necessary to monitor your progress and ensure that the cancerous tissues have been completely removed. These appointments may involve further imaging tests or endoscopic examinations to evaluate the treated area and detect any signs of recurrence.
Cancer in its early stages
Precancerous tumors that may progress to malignancy.
Endoscopic mucosal excision is generally performed by a gastroenterologist (a doctor who specializes in digestive system problems).
Endoscopic mucosal excision carries the following risks
Bleeding. During the treatment, this most common problem is frequently recognised and treated.
The oesophagus becomes narrower. When a lesion that encircles the oesophagus is removed, there is a chance that scarring will occur, narrowing the oesophagus and necessitating additional treatment.
Puncture of the skin (perforation). Depending on the size and location of the lesion excised, there is a small chance of a puncture through the digestive system wall.
If you experience any of the following signs or symptoms after undergoing endoscopic mucosal resection, contact your doctor or seek immediate medical attention:
- Fever \Chills
- Blood in the stool is bright red and black.
- Pain in the chest or abdomen
- Breathing problems
The day before the operation, you’ll get detailed instructions on what to do. These steps may differ depending on where the lesion or lesions being removed are located. The following will most likely be included in the instructions:
Fasting. You’ll be told when to start fasting. Before the operation, you may not be able to eat, drink, chew gum, or smoke after midnight. The day before your operation, you may be advised to follow a clear liquid diet.
The colon has to be cleaned. If the operation requires you to empty your intestines and clear your colon, you’ll most likely need a liquid laxative or an over-the-counter enema kit.
Throughout the process
You can expect the following during an endoscopic mucosal resection:
- It is your responsibility. Before the procedure, you’ll be asked to change into a gown. You’ll be lying on your side on a cushioned table for the operation.
- A local anesthetic is a kind of anesthetic that is used to If the endoscope is put through your throat, you may be sprayed with a numbing solution or asked to gargle a solution to make the procedure more pleasant.
- Sedation. During the operation, you will be anesthetized. You may feel some movement or pressure throughout the operation if you’ve been given mild sedation, but you shouldn’t be in any discomfort. Alternatively, you might be extremely sedated. Consult your gastroenterologist.
- Monitoring. While the doctor performs the operation, nurses or other experts will check your heart rate, blood pressure, blood oxygen level, and comfort.
After the operation
you’ll be kept in a recovery room until the sedative’s effects have gone off. You’ll get written instructions on when you may start eating and drinking again, as well as when you can return to your usual activities.
Within 24 hours of the operation, minor side effects may develop, including:
Adverse effects of the sedative. You may continue to feel drowsy, and nausea and vomiting may occur.
You may develop sore throat. Your throat may be painful if the endoscope was directed down your esophagus.
Constipation or cramping. You may have gas, bloating, or cramping following the surgery if the air was pushed into your digestive tract to make it more accessible.
After the operation
you’ll be given written instructions on when to contact your doctor or seek emergency medical attention. The following signs or symptoms may suggest a severe endoscopic mucosal resection complication:
- Stool in black
- Blood in the faeces is bright crimson.
- Pain in the chest or abdomen
- Breathing problems
A follow-up visit with the gastroenterologist will most likely be scheduled to discuss the results of your endoscopic mucosal resection and the laboratory testing done on lesion samples. The following are some questions to ask your doctor:
- Were all aberrant tissues able to be removed?
- What were the outcomes of the lab tests? Is it possible that any of the tissues were cancerous?
- Do I need to see an oncologist (cancer specialist)?
- Will I require extra treatment if the tissues are cancerous?
- How will you keep track of my health?