Endoscopic mucosal resection

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Endoscopic resection of the mucosa

The frequency of malignant degeneration (malignancy) of polyps on the mucosa of the esophagus, stomach, or colon is directly dependent on their size. Thus, with polyps up to 1 cm in diameter, malignancy is detected in 5% of cases, more than 3 cm - 10 times more often. It should be noted that re-emerging polyps are much more prone to malignant transformation than first detected. Also, with each new recurrence, the probability of malignant recurrence increases many times. With this in mind, it is necessary to radically remove the formations of the esophagus, stomach and colon. Radical removal of polyps is achieved by endoscopic resection of the mucous membrane.
Endoscopic resection or dissection (removal of the mucous membrane from the submucosal and partially muscular membrane) of the gastric, colon, or esophagus is one of the most effective and minimally invasive methods of treatment of epithelial and non-epithelial tumors in the superficial layers of these organs.
The undeniable advantage of endoscopic surgery for the patient is the low-traumatic nature of the operation because access to pathological formations in the stomach or intestines doctor carries through natural openings via the endoscope without disturbing the integrity of the tissue (without cuts). These methods are among the minimally invasive methods of treatment of tumors, endoscopic resection, and dissection of the intestinal mucosa or stomach have a number of obvious advantages over open surgery - open abdominal surgery with large incisions, risk of complications, and long hospital stay and recovery.

What are the benefits of endoscopic mucosal resection?

Modern endoscopic technologies allow not only early diagnosis of precancerous and tumor changes of the mucous membrane but also their safe treatment using minimally invasive organ-preserving techniques. Existing endoscopic techniques allow for the removal of the formation of the gastrointestinal tract more than 15-20 mm in diameter in a single block.
Endoscopic access allows:

• to cut the affected tissues;
• check them for cancer cells;
• clarify the previous diagnosis;
• completely remove a small tumor.

During the procedure, you can get a tissue sample for laboratory examination - take a biopsy. If the procedure is performed on time, it can stop non-infiltrating (non-aggressive) stage 1-2 cancer, prevent the spread of cancer cells and their entry into the lymph nodes, where they can metastasize.
This method has many advantages over traditional surgery:

• there are no incisions or punctures: endoscopy uses natural holes;
• rapid rehabilitation without prolonged disruption of the usual way of life;
• healing without consequences: scars are not formed on the mucous membrane;
• the procedure is safe: complications are extremely rare and reversible;
• everything is completely painless for the patient.

What are the indications for endoscopic resection of the mucosa?

For effective treatment, the clinical situation must meet a number of conditions:

• superficial cancers at an early stage (early cancer);
• the process is limited to the mucous membrane;
• the size of the tumor is not more than 20 mm;
• no metastases in the lymph nodes;
• no ulcers and scars on the mucous membrane;
• benign formations of the mucous membrane of the gastrointestinal tract of any size.

If there is infiltrative (penetrating the tissues) tumor growth, the decision on the method of resection is made individually for each patient.

How is endoscopic resection of the mucosa performed?

The process of resection of the mucosa takes place in several stages:

1. Endoscopic resection of the mucous membrane of the intestine, stomach, or esophagus is performed under general anesthesia and takes from half an hour to 1-2 hours, depending on the complexity of the patient. First, to confirm the diagnosis and clear localization of the tumor, specialists perform colonoscopy or esophagogastroduodenoscopy, then with the help of thermocoagulation mark the boundaries of the operating area.
2. The endoscopist inserts a gastroscope or colonoscope and examines the surface of the mucosa under multiple magnifications, using special techniques to detect cancer cells: staining, special lighting.
3. Then an endoscopic injection of saline into the submucosal layer provides the rise and separation of formation from the muscular layer of the wall of the operated organ.
4. Upon detection of a suspicious area, the doctor uses special tools to remove or excise the affected tissue, and then stops the bleeding from damaged vessels during resection.
5. The removed tissues are sent to the laboratory for histological examination.

The laboratory finds out to what type the received cells belong. If they are cancerous, they determine the type of tumor and the degree of aggressiveness of cancer. The obtained data will be the basis for further treatment.
The use of such techniques allows the specialists of our clinic to provide highly effective treatment of cancer of the gastrointestinal tract, which is one of the most common types of oncopathology, at an early stage. The total length of stay in our clinic of patients who have been prescribed such operations, as a rule, does not exceed 2-3 days.
Mucosal resection is a minimally invasive operation. Therefore, it is necessary to follow all postoperative recommendations of the doctor, including diet for the healing of the injured mucosa.