Endoscopic mucosal resection : established indications, potential indications and perspectives

Endoscopic mucosal resection (EMR) has progressed tremendously since the first report of saline injection to assist removal of a flat colonic polyp in 1973 (Deyhle- 1973). However, it was Tada who first applied an EMR technique (termed "stripped-off biopsy") to early (gas- tric) cancer (Tada-1984). Since these early reports, new techniques have been developed and are being applied to early cancers and high grade dysplasia in the esophagus, stomach, duodenum and colon. As experience has grown, indications have evolved and endoscopists are becoming more aggressive by performing larger resec- tions. As these techniques evolve, it becomes critical that endoscopists understand the appropriate indications for this procedure and that they stay abreast of new developments. This is the purpose of this paper.