EMR for gastric adenoma may be insufficient. EndoTODAY 이준행

[Gastric cancer 854. EMR for gastric adenoma may be insufficient]

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ESD for small gastric adenoma is not covered by the insurance. EMR is the only practical option. However, it is difficult to make enough resection margins with EMR. I prefer ESD even for small gastric adenomas. Following case shows why I love ESD rather than EMR for gastric adenoma especially when the tumor margin is uncler.

55 years old woman was referred for the endoscopic treatment of recurrent tumor after gastric EMR for adenoma.

Three months ago, gastric EMR was done for gastric adenoma of the antrum.

In the first follow up endoscopy with biopsy, a locally recurrent tumor (M/D adenocarcinoma).

ESD was done as usual.

Pathological evaluation for a small EMR specimen is difficult. I hope I can do ESD when I think it is necessary. Patient first! Not the government money!