Endoscopic Mucosal Resection (EMR)

Important! This exam requires that you have an empty stomach. You should not consume any food for 8 hrs before the procedure. Stop drinking all fluids (including clear liquids and water) 4 hrs before the exam (minimal sips are allowed to take your usual medications). Avoid gum and hard candy.

Medications: If you take insulin or other diabetic medicines, dosage adjustments will be provided for you. Bring your insulin with you so that you can take it after the procedure if necessary. If you are on blood thinners such as Coumadin, Plavix (clopridogrel), Pradaxa, Eliquis, etc. let us know at the time of scheduling because they may need to be held.  All other meds should be taken at their usual time with a few sips of water.

What is it and why do I need it?

EMR is a specialized technique that removes precancerous and early cancerous tissue from the gastrointestinal tract avoiding the need for surgery. This technique can be performed almost anywhere in the gastrointestinal tract but is most often used in the esophagus and colon. Many precancerous lesions and early cancers that have not deeply invaded into the esophageal, stomach or intestinal wall are amenable to EMR. These lesions carry a very low risk of metastatic spread to lymph nodes and other organs. Thus, in most cases, EMR provides accurate diagnosis as well as cure.

The risks

You will be asked to sign a consent form at the time of the exam. The risks of EMR are low but do include bleeding, infection, perforation, tearing, aspiration, medication reactions, heart/lung problems and rarely the need for surgery. If you have concerns about these risks, please contact your physician before your procedure. You will also be able to discuss this with your physician at the time of the exam.

The procedure

In the preparation area, you will be asked questions about your health history. Your procedure usually takes 30-90 minutes and you will be sedated for it. For lesions in the upper gastrointestinal tract, the procedure will be part of an EGD.  For lesions in the colon, the procedure will be part of a colonoscopy. Please refer to these exams as appropriate.  

After the procedure

In the recovery unit, your physician will discuss the results with you and give you discharge instructions. You and your driver will remain there until your sedation has worn off to a satisfactory level.  Rarely, patients are admitted to the hospital for observation or if complications occur. After discharge, you may  resume your usual activities and diet and return to work the following day. However, you may not drive, make important decisions or operate machinery the rest of the day.  You must have someone at least 18 yrs old with you during the entire time including check-in, recovery, and to drive you home after the exam (a taxi or bus is not an option).  A report will be sent to your referring physician. If any biopsies are taken, you will be contacted with the results.