Post written by Karl Kwok, MD, FASGE, and Andrew Giap, MD, FASGE, from the Southern California Permanente Medical Group, and Brian Lim, MD, FASGE, from United Medical Doctors, Irvine, and the University of California, Riverside, School of Medicine, Riverside, California, USA.

Interventional endoscopists have known the advantages of EMR for many years. However, published EMR data in a large, community-based multispecialty group (not only on its clinical benefits, but also its operational benefits) had always been lacking. We were motivated to share our experience in promoting this organ-preserving technique.

First, despite the 55-year collective experience among us 3, we remained surprised that patients were still getting surgical referrals for endoscopically removable lesions–sometimes, even from gastroenterologists. In fact, on numerous occasions, EMR referrals came from surgeons.

Second, given the importance of operational efficiency in today’s health economics status, we were curious to see the operational advantages of EMR in a large, multispecialty group compared with conventional surgery.

This study confirms our understanding that EMR for appropriate lesions has multiple clinical and operational advantages such as procedure/operative times, patients needing packed red blood cells, and initial hospital length of stay, even in a community-based practice. We were pleasantly surprised that EMR patients, despite being sicker than surgical patients, had an overall survival advantage.

Thus, we believe these data are beneficial for practices looking to start or expand their interventional endoscopy service line.

Graphical abstract

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.