{"entity":{"id":"endoscopic-resection","kind":"technology","name":"Endoscopic resection (EMR / ESD)","aka":[],"tldr":"Endoscopic resection lifts an early cancer of the oesophagus or stomach with an injection and cuts it out from inside with a snare or electrosurgical knife, keeping the organ intact. It cures cancers confined to the mucosa (T1a) and gives a definitive depth reading; deeper invasion or lymph node spread still needs surgery.","summary":"Endoscopic mucosal resection (EMR) for small lesions and endoscopic submucosal dissection (ESD, developed in Japan) for larger en-bloc resections cure mucosal (T1a) cancers and high-grade dysplasia with organ preservation. Standard for Barrett's neoplasia, early squamous cancer, and early gastric cancer meeting Japanese criteria. Radiofrequency ablation eradicates residual Barrett's epithelium. Requires expert endoscopy and careful histologic staging; submucosal invasion (T1b) with risk features needs surgery.","status":"standard-of-care","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Endoscopic_submucosal_dissection","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Endoscopic_submucosal_dissection"}],"tags":[],"related":[],"cancers":["esophageal","gastric","early-gastric-cancer"],"sections":["surgery","early-detection"],"technologies":["thermal-ablation"],"targets":[],"drugs":[],"companies":["cellseed"],"institutions":[],"pathways":[],"terms":["barretts-esophagus","endoscopic-resection-term"],"trials":["nct04275986","nct03274414","nct06599775"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Submucosal injection lifts the lesion; a snare (EMR) or electrosurgical knife (ESD) resects it en bloc for histologic assessment of depth and margins.","strengths":["Organ preservation, low morbidity","Curative for T1a disease","Provides definitive staging"],"limitations":["Operator-dependent, long learning curve for ESD","Not curative for deeper invasion or nodal disease","Requires endoscopic surveillance afterwards"],"since":1990},"route":"/technologies/endoscopic-resection/","neighbours":{"cancer":[{"id":"ampullary","kind":"cancer","name":"Ampullary cancer (ampulla of Vater)","route":"/cancers/ampullary/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"early-gastric-cancer","kind":"cancer","name":"Early gastric cancer","route":"/cancers/early-gastric-cancer/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"gist","kind":"cancer","name":"Gastrointestinal stromal tumour (GIST)","route":"/cancers/gist/"},{"id":"oesophageal-adenocarcinoma","kind":"cancer","name":"Oesophageal and junctional adenocarcinoma","route":"/cancers/oesophageal-adenocarcinoma/"},{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"},{"id":"oesophageal-squamous-cell-carcinoma","kind":"cancer","name":"Oesophageal squamous cell carcinoma","route":"/cancers/oesophageal-squamous-cell-carcinoma/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"gastric-endoscopic-screening","kind":"technology","name":"Gastric cancer endoscopic screening (East Asia)","route":"/technologies/gastric-endoscopic-screening/"},{"id":"thermal-ablation","kind":"technology","name":"Thermal ablation (RFA, microwave, cryo)","route":"/technologies/thermal-ablation/"}],"company":[{"id":"cellseed","kind":"company","name":"CellSeed","route":"/companies/cellseed/"}],"term":[{"id":"barretts-esophagus","kind":"term","name":"Barrett's oesophagus","route":"/terms/barretts-esophagus/"},{"id":"colonoscopy","kind":"term","name":"Colonoscopy","route":"/terms/colonoscopy/"},{"id":"depth-of-invasion","kind":"term","name":"Depth of invasion (DOI)","route":"/terms/depth-of-invasion/"},{"id":"endoscopic-resection-term","kind":"term","name":"EMR and ESD (endoscopic mucosal resection, endoscopic submucosal dissection)","route":"/terms/endoscopic-resection-term/"},{"id":"endoscopy","kind":"term","name":"Endoscopy (EGD, EUS, ERCP)","route":"/terms/endoscopy/"},{"id":"gastrectomy","kind":"term","name":"Gastrectomy","route":"/terms/gastrectomy/"},{"id":"lymphovascular-invasion","kind":"term","name":"Lymphovascular invasion (LVI)","route":"/terms/lymphovascular-invasion/"},{"id":"colorectal-palliation-obstruction-pain","kind":"term","name":"Palliation in colorectal cancer: obstruction, stents, stomas and liver capsule pain","route":"/terms/colorectal-palliation-obstruction-pain/"}],"trial":[{"id":"nct03274414","kind":"trial","name":"A Clinical Trial of Endoscopic Surgery Followed by Chemotherapy and Proton Radiation for the Treatment of Tumors in the Sinus and Nasal Passages","route":"/trials/nct03274414/"},{"id":"nct04275986","kind":"trial","name":"Concurrent Chemoradiotherapy After Endoscopic Resection for Stage I Esophageal Carcinoma","route":"/trials/nct04275986/"},{"id":"national-polyp-study","kind":"trial","name":"National Polyp Study","route":"/trials/national-polyp-study/"},{"id":"nct06599775","kind":"trial","name":"Study of Adebrelimab With Chemotherapy, Endoscopy and Sequential Chemoradiotherapy In Inoperable Esophageal Cancer","route":"/trials/nct06599775/"}],"idea":[{"id":"idea-field-interception","kind":"idea","name":"Intercept cancer at the field stage","route":"/ideas/idea-field-interception/"},{"id":"idea-non-endoscopic-barretts-screening","kind":"idea","name":"Non-endoscopic screening for Barrett's oesophagus and early adenocarcinoma","route":"/ideas/idea-non-endoscopic-barretts-screening/"}],"pathway":[{"id":"basement-membrane-tissue-barriers","kind":"pathway","name":"Basement membrane & tissue barriers","route":"/pathways/basement-membrane-tissue-barriers/"},{"id":"field-cancerisation","kind":"pathway","name":"Field cancerisation","route":"/pathways/field-cancerisation/"}],"collection":[{"id":"jsmo-jsco-guidelines","kind":"collection","name":"Japanese oncology guidelines (JSMO, JSCO and organ societies)","route":"/collections/jsmo-jsco-guidelines/"}],"roadmap":[{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}]}}