Endoscopic Mucosal Resection in the Setting of Barrett’s Esophagus

Endoscopic mucosal resection (EMR) is a technique that was originally developed in 1978 for early gastric cancer (1). Given the relative simplicity, safety and effectiveness of the technique, it has become an endoscopic alternative to surgery in resecting flat and polypoid neoplasms of the mucosa by longitudinal section through the submucosa for curative intent. Moreover, EMR is increasingly being used in submucosal neoplastic lesions and intramucosal cancers. Still considered a novel procedure by endoscopists outside Japan, the present article will outline the current indications for EMR as it pertains to Barrett’s esophagus and distal esophageal lesions. Other areas where EMR may be used, but not discussed in the present paper, include the stomach for gastric cancers, the colorectum for adenomas and, recently, the duodenum.