EMR - Endoscopic mucosal resection

PublishedJanuary 6, 2022

UpdatedJanuary 8, 2022

Long designation

EMR = Endoscopic Mukosa Resection ≈ snare polyp removal

Meaning

Standard procedure for the removal of colon polyps up to a size of 25 mm.

Types

Additional abbreviations are used to describe the process used in more detail:

c-EMR = conventional EMR

In the "conventional" or standard procedure, the polyp is first injected with a sterile liquid, which causes the polyp to lift. The polyp is then removed with a snare. The cold ablation (CSP) from hot ablation using electricity (HSP) are distinguished.

u-EMR = underwater EMR

In this newer procedure, the gas in the colon is first removed and the colon is flooded with a liquid instead. This reduces the tension on the intestinal muscle and allows the polyp to float so that it can be safely grasped with a sling in a healthy state. The polyp is then removed under water using hot ablation (HSP) the polyp is removed. Cooling the water reduces the thermal damage to the cutting current. Unfortunately, u-EMR cannot be used for every polyp, depending on its location.

f-EMR = fractioned EMR

Larger and/or flat polyps can sometimes not be removed in one piece, but only in one piece. in several parts or fractions. This technique is also known as piece-meal EMR (p-EMR). This increases the risk of incomplete resection by around 15%, so that a short-term follow-up check of the ablation site should be carried out after three months.

Related terms

This is to be distinguished from the so-called ESD (endoscopic submucosal resection), in which the polyp is removed in one center in one piece using a time-consuming knife technique. This procedure is used for very large, flat or complex polyps.