Endoscopic Mucosal Resection
If a small polyp-like nodule is seen in the esophagus, an endoscopic mucosal resection can be done to try to remove it. This procedure is performed using a small cap with a small wire loop that fits on the end of the endoscope.
The nodule is first injected with a solution that will decrease bleeding after the nodule is removed. This solution also forms a blister under the nodule, allowing the doctor to remove it without damaging the rest of the esophagus. The nodule is suctioned into the cap, and the wire loop is closed while cautery is applied.
The tissue can then be examined under a microscope to determine if all of the cancer or dysplasia has been removed. If the cancer is not completely removed, further endoscopic mucosal resections may be needed to completely remove the cancer. When the cancer is completely removed, additional treatment — such as photodynamic therapy or radiofrequency ablation — may be done to prevent recurrence.
Research in the Barrett's Esophagus Unit related to endoscopic mucosal resection involves evaluating therapeutic effectiveness, safety and predictors of complications — including stricture formation, bleeding or perforation — associated with using the procedure for Barrett's esophagus with high-grade dysplasia or early esophageal adenocarcinoma.