Endoscopic treatment: EMR and ESD

Esophageal superficial cancers with negligible risk for lymph node metastasis can be cured by endoscopic local resection. Endoscopic mucosal resection (EMR) is a conventional technique, which can resect relatively small lesion by using a snare. On the contrary, endoscopic submucosal dissection (ESD) can resect superficial lesion in an en bloc fashion irrespective of the size or presence of submucosal fibrosis, which has made the indication of endoscopic resection expanded. Although skillful hands in endoscopy and sufficient knowledge of possible complications are required, ESD is a promising technique as a minimally invasive treatment.