EMR and ESD (endoscopic mucosal resection, endoscopic submucosal dissection)
Removing an early cancer from the inside lining of the gut through an endoscope, with no external incision and the organ left in place.
Endoscopic mucosal resection lifts and snares lesions up to about 2 cm; endoscopic submucosal dissection, developed in Japan, cuts under larger lesions en bloc so the pathologist can judge depth and margins. Both cure mucosal cancers of the oesophagus, stomach and colon that have negligible node risk (T1a, well-differentiated, no lymphovascular invasion), which is why endoscopic screening in East Asia converts gastric and oesophageal cancer into an outpatient cure. Deeper (T1b) or poorly differentiated lesions still need surgery.
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