EMR is a technique used to obtain a larger and deeper specimen when compared to traditional biopsy during upper endoscopy (EGD). EMR allows for a larger specimen to be examined by the pathologist, which can improve the diagnostic accuracy of biopsies. EMR has higher bleeding and perforation risk than standard biopsies, but can be routinely done in a safe and effective manner in the outpatient setting.
EMR in Barrett’s Esophagus
For areas within the Barrett’s esophagus lining which are raised or depressed, and thus suspicious for cancer, a method called endoscopic mucosal resection (EMR) is used to remove the damaged lining. Using a snare delivered through an endoscope, tissue can be removed to a depth of about 2 mm and then evaluated to diagnose the seriousness of the disease. The benefit of EMR is that large biopsy specimens can be removed to render the lining flat. The disadvantage is that use of EMR for wide spread Barrett’s has an unacceptable complication rate. Therefore, focal EMR for specific areas of concern has been followed 2 months later by BARRX-HALO to safely and effectively remove the remainder of the Barrett’s esophagus.
What about Aspirin?
Aspirin should be discontinued for 5 days prior to EMR.
What about Plavix® (clopidogrel)?
Plavix® (clopidogrel) should be discontinued for 5 days prior to EMR.
What about Coumadin®?
Your physician will discuss holding Coumadin® with you prior to scheduling your procedure.
What about Pradaxa® (dabigatran)?
Please stop taking Pradaxa® (dabigatran) 36 hours before your EMR. Pradaxa® (dabigatran) has an extremely short half-life, unlike Coumadin®, which means the blood thinning effect is gone after 24-36 hours after stopping the medication.