TECHNIQUES FOR ENDOSCOPIC PIECEMEAL MUCOSAL RESECTION (EPMR) IN THE TREATMENT OF COLORECTAL NEOPLASMS

Abstract

The endoscopic mucosal resection (EMR) or endoscopic piecemeal mucosal resection (EPMR) techniques using snares are still important as one of the treatment methods for colorectal neoplasms even after the advent of the endoscopic submucosal dissection (ESD) technique which employs special knives. Most early colorectal neoplasms can be treated with the EMR or EPMR technique. However, the indications for the ESD technique are fairly limited. The procedure time is shorter and the perforation rate is much lower for EPMR than for ESD. On the other hand, the postoperative bleeding rate is slightly higher and the local recurrence rate is much higher with the former. Recurrent lesions can usually be treated endoscopically when they are encountered. However, a careful and complete resection during the first procedure is most important.