Endoscopic Mucosal Resection (EMR)
The Center for Thoracic Oncology at Boston Medical Center is here to serve you and your family, to provide you with the most advanced and effective medical treatment in New England—as well as unmatched patient care. Our staff of compassionate diagnosticians, surgeons, physician assistants, nurse practitioners, and surgical nurses will work as a team to treat your esophageal cancer and lead you on the path to recovery in the most comfortable way possible. You will be treated in our state-of-the-art facilities using a multidisciplinary approach.
Endoscopic mucosal resection, or EMR, is one of the newer, more minimally invasive techniques we offer for our esophageal cancer patients who have small tumors that have not spread outside of the esophagus. It may also be beneficial for patients with Barrett's esophagus. In this simple procedure, we are able to locate, remove, and examine cancerous or precancerous lesions of the esophagus. The mucosa is the innermost lining of the esophagus, and it extends down into your gastrointestinal tract. Cancers in this tract often originate in the mucosa, thus making visualization and access to it essential for diagnosis and treatment.
How to Prepare
Before recommending EMR, your physician will meet with you, take a medical history, and perform a physical examination. He or she will review any imaging and order additional tests, if necessary. You may come in for a pre-admission visit to take care of these items and complete paperwork. Please bring a list of allergies and names and dosages of any medications, supplements, or herbs you take with you, and leave valuables at home. Your physician will advise you on any other specific instructions; it is important to follow them carefully. Please also arrange for a ride home following EMR.
What to Expect
Due to its minimally invasive nature, EMR is generally an outpatient procedure. Unlike traditional surgery, a hospital stay is usually not required, and you can resume normal activities soon after.
Once your throat area is numbed, a needle is inserted and the tumor is injected with a solution to decrease bleeding as well as to create a protective blister so that removal does not damage the rest of your esophagus. Then your physician will insert an endoscope, a small, flexible, lighted tube, with a cap and a small wire loop at the end. The tumor will be lifted and cut from the mucosa and sucked into the cap as high-frequency electrical energy is applied. The tissue can be analyzed in the laboratory, and EMR may be repeated if all of the affected tissue is not removed the first time. EMR combined with another treatment method, such as photodynamic therapy, is a common strategy for early-stage esophageal cancer.
After your procedure, you will rest in the recovery room for a few hours. We recommend avoiding strenuous activity for a few days after EMR. You will have a follow-up appointment in the coming weeks. Call us if you notice any redness, swelling, or pain, or have any concerns.