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Will ESD replace EMR for large colorectal polyps?

Drs. Bayudan, Munroe and Tewani discuss whether the benefits of ESD outweigh costs in time, money and training.
Endoscopic Instrument
Endoscopic Instrument

Dear colleagues,

Resection of polyps is the bread and butter of endoscopy. Advances in technology have enabled us to tackle larger and more complex lesions throughout the gastrointestinal tract, especially through endoscopic mucosal resection (EMR). Endoscopic submucosal dissection (ESD) is another technique that offers much promise for complex colorectal polyps and is being rapidly adopted in the West. But do its benefits outweigh the costs in time, money and additional training needed for successful ESD? How can we justify higher recurrence rates with EMR when ESD is available? Will reimbursement continue to favor EMR? 

I invite you to a great debate and look forward to hearing your own thoughts online and by email at [email protected].

Gyanprakash A. Ketwaroo, MD, MSc

Gyanprakash A. Ketwaroo, MD, MSc

Dr. Ketwaroo is assistant professor of medicine at Baylor College of Medicine, Houston and an associate editor for GI & Hepatology News.

In this issue of Perspectives, Dr. Alexis Bayudan and Dr. Craig A. Munroe make the case for adopting ESD, while Dr. Sumeet Tewani highlights all the benefits of EMR.

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