Esophageal Endoscopic Mucosal Resection (EMR)

Endoscopic mucosal resection, also known as EMR, is a procedure to remove or resect abnormal tissue from the lining of the digestive tract. Endoscopic mucosal resections are performed by doctors at the University of Michigan, ranked best in the state for Gastroenterology by U.S. News & World Report.

How Is an EMR Performed?

EMR are performed at our Medical Procedures Unit. Similar to standard endoscopies, the physician uses an endoscope, which is a flexible tube with a light source and a camera, to identify the abnormality. The endoscope is inserted in the mouth or through the rectum. Before beginning the procedure, you will have an intravenous (IV) line started to give you a sedative or anesthesia. You will lie on your left side. Your oxygen level, blood pressure and pulse will be continuously monitored before, during and after the procedure. For  upper endoscopies, your throat will be numbed with a spray.  

Once the endoscope is advanced to the lesion in question, the doctor will inject a solution under and around the lesion to raise the lesion and create a safe cushion or buffer. After the lesion is raised, the doctor will remove the tissue  using various tools before sending the tissue to the laboratory for evaluation. There usually is no pain associated with this procedure  The procedure takes about 1-2 hours, but expect your visit to last an additional 2 to 3 hours to allow for pre-procedure preparation, and post-procedure recovery and  follow-up with the doctor.

Who Needs an Endoscopic Mucosal Resection?

EMR are performed on lesions in the digestive tract that are large and/or contain abnormal cells (including cancer). EMR helps clarify the diagnosis, helps stage cancers, and ideally eliminates the need the more invasive surgeries and associated hospitalizations. 

Conditions that can be treated with EMR:

  • Barrett’s esophagus with high grade dysplasia or superficial esophageal adenocarcinoma (a type of esophageal cancer)
  • Stomach polyps or masses, including superficial or submucosal cancers
  • Duodenal polyps or masses, including superficial or submucosal cancers
  • Colon or rectal polyps

What Are the Potential Complications for an Endoscopic Mucosal Resection?

EMR is generally a very safe procedure. Some of the potential but rare complications include bleeding and a puncture (or perforation) in the lining of the gastrointestinal tract. If you notice any blood in your stool, black stool, fever, chills, vomiting, chest pain, stomach pain, or shortness of breath, contact your doctor as instructed on your discharge papers.

What do I need to do prior to an EMR?

You will have fasting instructions for the day of the procedure and your doctor may alter certain medications. If your procedure is for the colon, you may need to take a laxative before the procedure. You must have a licensed driver of at least 18 years old to accompany you and drive you home because the sedatives or anesthesia will make you drowsy.

What Happens After EMR?

After the EMR procedure, you will be taken to a recovery room where your driver can join you. You will receive detailed recommendations regarding diet, medications, and follow up. The results of the procedure will be communicated to your referring physician(s). Rarely, after EMR of the esophagus, patients have mild chest discomfort for a few days. If you have EMR of the esophagus, your doctor will ask you to consume a liquid diet for 1 to 2 days after the procedure, then soft or pureed food for 2 days, and to continue taking your proton pump inhibitor acid-reducing medication twice a day. You may also be given a prescription for a medicine to coat the esophagus to ease discomfort and help healing. Complete removal of diseased tissue may require several endoscopies.

Make an Appointment

To make an appointment to be evaluated for an esophageal endoscopic mucosal resection or other GI procedure, call 888-229-7408.