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Tissue damage of different submucosal injection solutions for EMR.

Abstract：

BACKGROUND:When choosing submucosal injection solutions for EMR, tissue damage should be considered, as well as the lesion-lifting ability. The objective of the study was to find out the potential tissue damage of submucosal injection solutions. METHODS:The submucosal injection solutions examined were the following: normal saline solution (NS), 3.75% NaCl, 20% and 50% dextrose water (DW), a glycerin solution (Glyceol; 10% glycerin with 0.9% NaCl plus 5% fructose), and two hyaluronic acid (HA) solutions (0.25% 1900 kDa/NS solution and 0.125% 1900 kDa/ Glyceol solution). Furthermore, DW with different concentrations (5%, 10%, 15%, 30%, 40%) also was examined to find out the tolerable concentration without tissue damage. A total of 2 mL of each solution per stomach were injected by endoscopy into the submucosal layer at the separate sites of 4 living minipigs. Two minipigs were euthanized after 30 minutes of endoscopic observations, and the others were euthanized after additional endoscopic observations a week after injection. RESULTS:There was no apparent tissue damage in NS, 5% and 10% DW, Glyceol, or two solutions of HA, whereas, hypertonic solutions, except Glyceol and 10% DW, have more or less potency of tissue damage. In 3.75% NaCl and DW with concentrations of >or=20%, considerable tissue damage was observed, which might affect resected EMR specimens and ulcer healing. CONCLUSIONS:Use of hypertonic solutions except Glyceol is not recommended with respect to tissue damage. A combination of HA and Glyceol is the most favorable submucosal injection solution, considering tissue damage and lesion-lifting ability.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Fujishiro M,Yahagi N,Kashimura K,Matsuura T,Nakamura M,Kakushima N,Kodashima S,Ono S,Kobayashi K,Hashimoto T,Yamamichi N,Tateishi A,Shimizu Y,Oka M,Ichinose M,Omata M

doi

10.1016/j.gie.2005.07.052

keywords:

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

933-42

issue

6

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(05)02667-2

journal_volume

62

pub_type

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