Solutions for submucosal injection in endoscopic resection: a systematic review and meta-analysis

Endoscopy International Open
Alexandre Oliveira FerreiraMario Dinis-Ribeiro

Abstract

Submucosal injection is standard practice in endoscopic mucosal resection of gastrointestinal lesions. Several solutions are used. Our aim was to systematically review their efficacy and safety. We performed a systematic review and meta-analysis using a random effects model of randomized controlled trials (RCTs) from MEDLINE. Studies in animal models were qualitatively assessed for efficacy and safety. In total, 54 studies were qualitatively assessed. Eleven RCTs were analyzed, two of which were on endoscopic submucosal dissection (ESD). The quantitative synthesis included nine RCTs on endoscopic mucosal resection (EMR), comprising 792 subjects and 793 lesions. Mean lesion size was 20.9 mm (range 8.5 - 46 mm). A total of 209 lesions were randomized to sodium hyaluronate (SH) vs normal saline (NS), 72 to 50 % dextrose (D50) vs NS, 82 to D50 vs SH, 43 to succinylated gelatin, 25 to hydroxyethyl starch and 36 to fibrinogen. In total, 385 were randomized to NS as controls. NS and SH are the best studied solutions and seem to be equally effective in achieving complete resection (OR 1.09; 95 %CI 0.82, 1.45). No solution was proven to be superior in complete resection rate, post-polypectomy bleeding or coagulation syndrome/perforation...Continue Reading

Citations

Nov 16, 2018·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Ignacio BonVicente Lorenzo-Zúñiga
Apr 9, 2019·Clinical Endoscopy·Eun Ran Kim, Dong Kyung Chang
Apr 8, 2020·Pharmaceutics·Cristina Moles-ArandaBeatriz Clares-Naveros
Nov 30, 2018·World Journal of Gastrointestinal Endoscopy·Vicente Lorenzo-ZúñigaJaume Boix
Feb 28, 2019·World Journal of Gastroenterology : WJG·Rui CastroMário Dinis-Ribeiro
Apr 25, 2020·Journal of Clinical Medicine·Cristina Moles-ArandaJosé Antonio Morales-Molina

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Methods Mentioned

BETA
dissection
biopsies
dissect

Software Mentioned

Mesna
Review Manager
STATA

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