title: Endoscopic mucosal resection and endoscopic submucosal dissection in esophageal and gastric cancers.
abstract: OBJECTIVE
  To summarize the literature to date on endoscopic mucosal removal techniques as applied to the upper gastrointestinal tract, predominantly the stomach and esophagus. This is an area that has rapidly advanced in terms of new procedures and techniques with a large body of outcomes that support their use.
  
  
  RESULTS
  The resection techniques can be divided into two forms, mucosal resection and submucosal dissection. Mucosal resection is typically done with cap techniques and is more suitable for removable of neoplastic lesions that are less than 1.5 cm in size. Submucosal dissection techniques are more difficult, associated with increased complications, and typically reserved for lesions greater than 1.5 cm and less than 3 cm in size. Ideal lesions for mucosal resection are generally flat and are located in areas easily accessible by the endoscope.
  
  
  CONCLUSIONS
  Endoscopic tissue removal methods are capable of removing neoplastic lesions en bloc in the upper gastrointestinal tract. These techniques fulfill cancer treatment guidelines by having histological confirmation of total removal of neoplastic lesions with assessment of the margins of resections. Long-term clinical outcomes of these techniques are emerging and seem promising in terms of disease-free and overall survival.
authors: Barrett's Esophagus Unit, Mayo Clinic, Rochester, Minnesota 55905, USA. Wang.kenneth@mayo.edu
authors: Kenneth K
authors: KK
authors: Wang
authors: Ganapathy
authors: G
authors: Prasad
authors: Jianmin
authors: J
authors: Tian
mesh_terms: D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome