This CME activity consists of the ASGE video, Endoscopic Management of Early Stage Cancers of the Esophagus and Stomach, followed by a post-assessment and evaluation.

This program is a comprehensive, evidenced-based review of the current endoscopic techniques for endoscopic resection of malignant and premalignant lesions of the esophagus and stomach.  The recommended, as well as the evolving, indications for EMR/ESD are introduced. Prior to showing the detailed procedure, the needed preparations, learning curve, various accessories, and equipment needed for EMR/ESD are introduced. Also included are novel methods (magnifying NBI, confocal endomicroscopy, chromoscopy, etc.) for precise delineation of the margins prior to EMR/ESD of the lesion. Detailed demonstrations of EMR/ESD in the esophagus and stomach are shown. These demonstrations are in HD and categorized by specific location (cardia, body, antrum, prepyloric area). Detailed explanation of the different strategies for EMR/ESD according to the specific location, and nature of the tumor (depth of invasion, presence of fibrosis, size, etc.) is given. The limitations of EMR/ESD (incomplete resection, under staging) and novel techniques to cope with these problems are shown. The various immediate and delayed complications of EMR/ESD and how to manage them are explained. Finally, the appropriate method for handling resected specimens and how to prepare specimens for optimal pathological analysis is demonstrated. This program is comprehensive and concise and focuses on delivering practical information for beginner as well as advanced endoscopists.  

See a preview of this video content here.

Practicing gastrointestinal endoscopists, gastroenterologists, gastroenterology fellows and trainees, medical residents, physician assistants and nurses.

Upon completion of this educational activity, participants will be able to:

• Recognize the indications, limitations, and preparations for EMR/ESD of the esophagus and stomach.
• Describe how to approach the target lesion according to specific anatomical location and what accessories can provide the 'edge' in specific situations such as bleeding, perforation, fibrosis, etc. during EMR/ESD. 
• Discuss the importance of specimen handling and describe how to prepare the specimen for final pathological analysis.

Video Release Date:    May 1, 2013
Online CME Release Date:  September 1, 2013
Most Recent CME Review Date:  January 23, 2016
CME Expiration Date:  January 23, 2019

Expected Time of Activity Completion:  75 Minutes (1.25 CME Credit)

Windows Requirements: Operating system: Windows 7+
Browser: Internet Explorer 8+, Firefox 10+, Google Chrome 10+
Internet connection: DSL, cable modem, or other high-speed connection
Flash: Adobe® Flash® Player 12+

Macintosh Requirements:
Operating system: Mac OS X 10.6.8+
Browser: Mozilla Firefox 10+, Safari 5+, Google Chrome 10+
Internet connection: DSL, cable modem, or other high-speed connection
Flash: Adobe® Flash® Player 12+

This CME activity consists of an ASGE video, followed by a post-assessment.  All materials required to complete the activity, including the video, are contained within the activity.

To complete this activity,
1. View the video.
2. Complete the Post –assessment by selecting the single best answer for each multiple choice question. You will be able to change your answer at any time until you click on the finish button.
3. Complete the Evaluation.

You may complete the activity in one sitting, or you may save your work in progress and complete it at a later date. However, to earn CME credits, you must complete the activity prior to the CME expiration date. 

In order to claim credit, you must complete the Post-assessment and Evaluation. Completed CME will be tracked in your account and you can print a record of this CME activity at any time. 

For technical difficulties, please contact ASGE between the hours of 8:30am and 5pm Central Time at 1-866-353-ASGE (2743). For questions related to content or CME credits, please email education@asge.org.