The Gastroenterology & Endoscopy Podcast
Episode 147: Endoscopic Management of Premalignant Lesions

Quick Summary:
An evidence-based overview of EMR vs ESD for premalignant lesions, including technique selection, outcomes, and complication rates.

Key Points:
• EMR: Preferred for lesions <15mm, 0.5-1% perforation risk
• ESD: Better for lesions >20mm, 83-98% en bloc resection rate
• Technique selection based on lesion size, location, and suspected invasion
• Watch for delayed bleeding and stricture formation

Essential Reading:
1. ASGE Guidelines on ESD
   https://www.asge.org/docs/default-source/guidelines/asge-guideline-on-endoscopic-submucosal-dissection

2. Cleveland Clinic EMR Protocol
   https://my.clevelandclinic.org/health/treatments/21148-endoscopic-mucosal-resection

3. Mayo Clinic ESD Guide
   https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/esophageal-endoscopic-submucosal-dissection/mac-20552628

Additional Resources:
• Clinical Outcomes Study - https://www.sciencedirect.com/science/article/abs/pii/S0016510712023760
• ESD Technical Analysis - https://pmc.ncbi.nlm.nih.gov/articles/PMC3072634/
• Comparative Review - https://pmc.ncbi.nlm.nih.gov/articles/PMC5824597/
• Technical Developments - https://www.sciencedirect.com/science/article/abs/pii/S0960740422000354

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