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Modified endoscopic mucosal resection techniques for treating precancerous colorectal lesions. 2021
Georgios Tziatzios, and
Paraskevas Gkolfakis, and
Vasilios Papadopoulos, and
Ioannis S Papanikolaou, and
Lorenzo Fuccio, and
Antonio Facciorusso, and
Alanna Ebigbo, and
Stefan Karl Gölder, and
Andreas Probst, and
Helmut Messmann, and
Konstantinos Triantafyllou
Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece (Georgios Tziatzios, Ioannis S. Papanikolaou, Konstantinos Triantafyllou).
Endoscopic mucosal resection (EMR) is a technique allowing efficacious and minimally invasive resection of precancerous lesions across the entire gastrointestinal tract. However, conventional EMR, involving injection of fluid into the submucosal space, is imperfect, given the high rate of recurrence of post-endoscopic resection adenoma, especially after piecemeal resection. In light of these observations, modifications of the technique have been proposed to overcome the weakness of conventional EMR. Some of them were designed to maximize the chance of en bloc resection-cap-assisted EMR, underwater EMR, tip-in EMR, precutting, assisted by ligation device-while others were designed to minimize the complications (cold EMR). In this review, we present their modes of action and summarize the evidence regarding their efficacy and safety.
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