Efficacy of submucosal injection of different solutions inclusive blood components on mucosa elevation for endoscopic resection.

Clinical and Experimental Gastroenterology
Oliver H Al-TaieWolfgang Fischbach

Abstract

Endoscopic resection has become the standard treatment for noninvasive gastrointestinal malignancies. In flat mucosal tumors, normal saline is frequently used for submucosal fluid injection in order to reduce the risk of complications during endoscopic resection. Recent studies have demonstrated longer-lasting mucosa elevation by injection of agents such as hyaluronic acid or glyceol, rather than normal saline. We investigated the efficacy of different blood components in comparison with other solutions for use as a submucosal fluid cushion. Normal saline, sodium hyaluronate, glyceol, hydroxyethyl starch, serum, plasma, and whole blood were evaluated for their effectiveness in creating a submucosal cushion. One milliliter of each solution was injected into the submucosa of 5 × 5 cm specimens of resected porcine stomach. Mucosa elevation was measured before and up to 60 minutes after injection. The shortest duration of mucosa elevation was observed after injection of normal saline, glyceol, and 0.125% hyaluronic acid. A significantly longer duration was obtained after injection of hydroxyethyl starch, 0.25% and 0.5% hyaluronic acid, serum, and plasma. However, whole blood generated a longer-lasting mucosa elevation than all othe...Continue Reading

Citations

Jul 7, 2012·Clinical and Experimental Gastroenterology·Stefano PontoneGiovanni Leonetti
Aug 27, 2013·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Takashi MitsuiYasuyuki Seto
Apr 26, 2015·Gastrointestinal Endoscopy·Antonio FacciorussoNicola Muscatiello
Aug 30, 2013·Expert Review of Gastroenterology & Hepatology·Ivo BoškoskiGuido Costamagna
Feb 9, 2020·Polymers·Valentina GianninoLuigi Maria Longo
May 9, 2015·World Journal of Gastroenterology : WJG·Antonio FacciorussoNicola Muscatiello
Jun 3, 2014·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Pan HuiLiu Hai Peng

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