ASGE Postgraduate Course at ACG: Innovative Practices for the Endoscopist of Today, Tomorrow and Beyond | October 2023-Advantages and Disadvantages of EMR vs ESD in the colon

Video Transcription

Video Summary

The video transcript discusses the use of Endoscopic Submucosal Dissection (ESD) and Endoscopic Mucosal Resection (EMR) for removing polyps in the colon. The presenters, Dr. Antonio Mendoza-Led and Dr. Shivangi Kothari, discuss the benefits and drawbacks of each technique. Dr. Mendoza-Led emphasizes the importance of optical diagnosis and classification systems to determine the appropriate treatment method. He also discusses the advantages of ESD, such as its ability to perform en bloc resections of large lesions and accurately determine pathological margins. However, he notes that ESD is time-consuming, technically challenging, and carries a higher risk of adverse events. On the other hand, Dr. Kothari argues that EMR is the preferred method for most benign colon polyps. She highlights its efficacy, safety, shorter learning curve, and time efficiency. She also discusses techniques to reduce the risk of recurrence with EMR, such as resecting all visible neoplasia and ablating the resection margins. In conclusion, both presenters agree that EMR is the preferred method for most benign colon polyps in the US, while ESD is reserved for cases with suspected cancer or significant fibrosis.

Asset Subtitle

Antonio Mendoza Ladd, MD, AGAF, FACG, FASGE and Shivangi Kothari, MD, FASGE

Keywords

Endoscopic Submucosal Dissection

Endoscopic Mucosal Resection

colon polyps

optical diagnosis

en bloc resections

benign colon polyps

recurrence