Portuguese Society of Digestive Endoscopy: recommendations for endoscopic mucosal resection[1]

Definitions and Rationale

Endoscopic mucosectomy or mucosal resection (EMR) is the resection through an endoscopic procedure of a piece of digestive wall including mucosal layer, muscularis mucosae and partially or completely the submucosal layer.

EMR is regarded a minimal invasive procedure, with low mortality rates whose results, within precise indications, are comparable with those after surgical resection. It may be considered a curative procedure for pre-malignant lesions and for malignant lesions limited to mucosa without or with minimal invasion of submucosal layer. Thus, the selection of superficial lesions, with or without use of chromoendoscopy, new imaging methods and EUS is fundamental; and the complete histopathological evaluation of specimens should allow the assessment of procedure quality and to determine the probability of cure - further treatment should result of a multidisciplinary decision. EMR should be performed at centres with experience in diagnostic and hemostasis techniques. Training in animals models should be regarded as helpful.

1 This text results from a Consensus Meetting in Lisbon, January 2006, by the Sociedade Portuguesa de Endoscopia Digestiva and the Divisão Portuguesa da Academia Internacional de Patologia.

1 This text results from a Consensus Meetting in Lisbon, January 2006, by the Sociedade Portuguesa de Endoscopia Digestiva and the Divisão Portuguesa da Academia Internacional de Patologia.