Endoscopic mucosal resection

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What you can expect

By Mayo Clinic staff

There are a few different versions of endoscopic mucosal resection. Ask your gastroenterologist about how your procedure will be performed. A common approach includes these steps:

  • Insertion of the endoscope and guiding the tip to the area of concern
  • Injecting a fluid under a lesion to create a kind of cushion between the lesion and healthy tissue underneath it
  • Applying gentle suction to the lesion to lift it up
  • Snaring and cutting the lesion to separate it from surrounding healthy tissue
  • Removing the abnormal tissue from your body
  • Marking the area with ink (tattoo) so that it can be found again with future endoscopic exams

During the procedure
During an endoscopic mucosal resection, you can expect the following:

  • Your role. You'll be asked to change into a gown before the procedure. During the procedure, you'll lie on your side on a cushioned table.
  • Sedation. You'll be sedated during the procedure. This may be moderate sedation that causes you to be relaxed and drowsy. If this is the case, you may feel some slight movement or pressure during the procedure, but you shouldn't feel any pain. Or you may be heavily sedated and not be alert at all during the procedure. You can discuss with your gastroenterologist which option is appropriate for you.
  • Monitoring. The gastroenterologist performing the procedure will be assisted by nurses or other professionals, who will monitor your heart rate, blood pressure, blood oxygen level and comfort.

After the procedure
After the procedure, you'll remain in a recovery room until most of the effect of the sedative has worn off. You'll receive written instructions about when you can start eating and drinking and when you can resume normal activities. You'll be advised not to do any of the following activities until the next day:

  • Drive
  • Return to work
  • Make important decisions

Relatively mild side effects may occur within the first 24 hours after the procedure. These may include:

  • Reactions to the sedative. The drugs used to sedate you may continue to cause drowsiness and may cause nausea and vomiting.
  • Sore throat. If the endoscope was guided down your esophagus, you may experience a sore throat.
  • Gas or cramps. A small amount of air may have been pumped into your digestive system to make it more accessible. This can result in gas, bloating or cramps after the procedure.

You'll also receive written instructions about when to call your doctor or get emergency care after the procedure. The following signs or symptoms may indicate a serious complication from endoscopic mucosal resection:

  • Fever
  • Chills
  • Vomiting
  • Black stool
  • Bright red blood in the stool
  • Chest or abdominal pain
  • Shortness of breath
  • Fainting
References
  1. Chandrasekhara V, et al. Endoscopic mucosal resection: Not your father's polypectomy anymore. Gastroenterology. 2011;141:42.
  2. Kantsevoy SV, et al. Endoscopic mucosal resection and endoscopic submucosal dissection. Gastrointestinal Endoscopy. 2008;68:11.
  3. Upper GI endoscopy. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy/upperendoscopy.pdf. Accessed Aug. 15, 2011.
  4. Liu JJ, et al. Endoscopic treatment of gastroesophageal reflux disease. American College of Gastroenterology. http://www.acg.gi.org/patients/gihealth/grdtrtmnt.asp. Accessed Aug. 15, 2011.
  5. Preparing for an upper GI endoscopy. American Gastroenterological Association. http://www.gastro.org/patient-center/procedures/upper-gi-endoscopy. Accessed Aug. 15, 2011.
  6. Preparing for a colonoscopy. American Gastroenterological Association. http://www.gastro.org/patient-center/procedures/colonoscopy. Accessed Aug. 15, 2011.
MY00813 Sept. 29, 2011

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