Endoscopic Mucosal Resection (EMR)

EMR was introduced in the late 90’s and was a breakthrough at that time as it allowed treatment of early GIT cancers via endoscopy alone, even less invasive than keyhole surgery. According to the current international data, EMR has a 75.8% en bloc resection rate, a 73.9% complete resection rate, a 1.9% recurrence rate after complete resection, and a 99% gastric cancer-specific survival rate. Recently, in a matched cohort study that compared EMR and gastrectomy, no difference was observed in the complication rates in terms of survival and recurrence between the groups. The risk of metachronous gastric cancer was higher in the EMR group, but shorter hospital stays and lower costs were reported as the benefits of the EMR procedure. Albeit the excellent outcome, this technique is limited by the tumor size and surgeons generally do not offer EMR to cancers larger than 2 cm.