ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding (Day One) | March 2025-Considerations for EMR and ESD

Video Transcription

Video Summary

In this lecture, the speaker explains the key differences between EMR (Endoscopic Mucosal Resection) and ESD (Endoscopic Submucosal Dissection), focusing on their applications in GI tract interventions. EMR is suitable for lesions smaller than 2 cm, while larger, more complex lesions are better handled by ESD. Developed initially in Japan, these techniques have been adopted in the American medical context over the last decade. Key aspects of performing these procedures include proper patient selection, understanding preparatory requirements, and managing potential complications, like perforation and bleeding. The pathology and tumor biology must guide decisions, with cases of poorly differentiated tumors or those with lymphovascular invasion often necessitating surgical consultation. The speaker emphasizes the importance of informed consent, the need for multidisciplinary discussions in tumor boards, and adherence to guideline-based follow-up. The session concludes with interactive questions, reinforcing key concepts about the advantages and complications of EMR and ESD.

Asset Subtitle

Vivek Kaul, MD, FASGE

Keywords

Endoscopic Mucosal Resection

Endoscopic Submucosal Dissection

GI tract interventions

tumor biology

multidisciplinary discussions

guideline-based follow-up