Endoscopic mucosal resection and endoscopic submucosal dissection

The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methods are used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. For this review the MEDLINE database was searched through September 2007 by using the key words "endoscopic lesion removal," "endoscopic mucosal resection, " "EMR," "endoscopic submucosal dissection," and "ESD." Technology Status Evaluation Reports are drafted by 1 or 2 members of The ASGE Technology Committee, reviewed and edited by The committee as a whole, and approved by the Governing Board of the ASGE When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment.