Advantages and disadvantages of available treatments for early gastrointestinal neoplasms
| Treatment category | Treatment | Advantages | Disadvantages |
|---|---|---|---|
| Endoscopic | Endoscopic submucosal dissection (ESD) | Noninvasive Achieves en bloc resection of lesions regardless of size or fibrosis Allows margin evaluation Lower cost vs surgery | Higher cost compared with EMR Longer procedural time compared with EMR Specialized training and facilities needed Risk of recurrence |
| Endoscopic mucosal resection (EMR) | Noninvasive Cost-effective Decreased procedural time Decreased length of stay More local experience and data than with ESD | No histologic margin control No resection of fibrotic lesions Risk of recurrence | |
| Surgical | Surgical excision | Lower rates of recurrence Not limited by size, fibrosis, or depth of involvement | Invasive More procedure-associated comorbidity Longer hospital length of stay Higher cost |