Endoscopic mucosal resection with 0.13% hyaluronic acid solution for colorectal polyps less than 20 mm: a randomized controlled trial

Journal of Gastroenterology and Hepatology
Naohisa YoshidaToshikazu Yoshikawa

Abstract

Adequate mucosal elevation by submucosal injection is important for definitive en bloc resection and prevention of perforation during endoscopic mucosal resection (EMR). The objective of this study is to determine the efficacy of 0.13% hyaluronic acid (HA) solution for high and sustained mucosal elevation during colorectal EMR. The study was a prospective randomized controlled trial; a total of 196 patients with colon polyps of < 20 mm diameter were enrolled and randomized in a 1:1 ratio to undergo EMR using either 0.13% HA or normal saline (NS). The primary outcome of the study was histopathologically confirmed complete resection. The secondary outcomes such as maintenance of high mucosal elevation and development of complications were also evaluated. Moreover, the relationship between complete resection and the experience of the endoscopist (veteran vs less experienced) was analyzed. Compete resection was achieved in 74 of 93 polyps (79.5%) in the 0.13% HA group and 63 of 96 polyps (65.6%) in the NS group (P < 0.05). High mucosal elevation was maintained in 83.9% of procedures in the 0.13% HA group and 54.1% in the NS group (P < 0.01). The frequency of complete resection achieved by less-experienced endoscopists was higher in...Continue Reading

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Citations

Dec 29, 2012·International Journal of Colorectal Disease·Naohisa YoshidaToshikazu Yoshikawa
Aug 31, 2010·Journal of Foot and Ankle Research·Brian J WelshAnne-Maree Keenan
Feb 12, 2011·Journal of Foot and Ankle Research·Marike van der LeedenJoost Dekker
Mar 4, 2014·International Journal of Colorectal Disease·Naohisa YoshidaYoshito Itoh
Dec 31, 2015·Current Gastroenterology Reports·Saowanee NgamruengphongMouen A Khashab
Oct 1, 2015·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Naohisa YoshidaYoshito Itoh
Jun 17, 2015·Gastrointestinal Endoscopy·UNKNOWN ASGE Technology CommitteeSubhas Banerjee
Mar 26, 2015·Gastrointestinal Endoscopy·Nicholas G BurgessMichael J Bourke
Apr 21, 2017·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Shiro OkaTakahisa Matsuda
Feb 6, 2017·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Ryohei HiroseYoshito Itoh
Feb 15, 2020·The American Journal of Gastroenterology·Tonya KaltenbachDouglas K Rex
Aug 9, 2019·World Journal of Gastroenterology : WJG·Benjamin MeierKarel Caca
Jun 5, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Naohisa YoshidaYuji Naito
Apr 29, 2020·Surgical Endoscopy·Tak Lit Derek FungKam Hung Kwok
Jan 4, 2021·International Journal of Colorectal Disease·Yutaka InadaYoshito Itoh
Jun 3, 2014·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Pan HuiLiu Hai Peng
May 22, 2020·Gastroenterology·Roupen DjinbachianDaniel von Renteln
Sep 30, 2019·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Matthew D Rutter, Rodrigo Jover

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