Efficacy of the Envelope Method in Applying Polyglycolic Acid Sheets to Post-Endoscopic Submucosal Dissection Ulcers in Living Pigs.

Endoscopic submucosal dissection Fibrin tissue adhesive Gastrointestinal hemorrhage Polyglycolic acid Stomach

Journal

Clinical endoscopy
ISSN: 2234-2400
Titre abrégé: Clin Endosc
Pays: Korea (South)
ID NLM: 101576886

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 05 01 2020
accepted: 07 04 2020
pubmed: 17 7 2020
medline: 17 7 2020
entrez: 17 7 2020
Statut: ppublish

Résumé

Application of polyglycolic acid (PGA) sheets using fibrin glue in post-endoscopic submucosal dissection (ESD) ulcers to prevent bleeding has been reported to be difficult with the conventional delivery method because of gravity. This study assessed the usefulness of the envelope-based delivery system with and against gravity in living pigs. PGA sheets were applied on post-ESD ulcers with and against gravity six times each using the conventional and envelope methods, respectively. The PGA sheet delivery time and the endoscopic and histological findings of the treated ulcer floors were compared. With gravity, the median PGA sheet application time was 1.00 (0.68-1.30) min/cm2 and 0.32 (0.18-0.52) min/cm2 with the conventional and envelope techniques (p=0.002), respectively, and against gravity, it was 1.20 (1.13-1.63) min/cm2 and 0.50 (0.39-0.58) min/cm2 (p=0.002), respectively. Against gravity, the endoscopic and histological findings revealed that the conventional group had insufficient fixation of the PGA sheets, but the envelope groups had sufficient fixation. The results with gravity were similar between the groups. The envelope method makes it possible to deliver PGA sheets to the stomach quickly and cover ulcers appropriately both with and against gravity in living pigs.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
Application of polyglycolic acid (PGA) sheets using fibrin glue in post-endoscopic submucosal dissection (ESD) ulcers to prevent bleeding has been reported to be difficult with the conventional delivery method because of gravity. This study assessed the usefulness of the envelope-based delivery system with and against gravity in living pigs.
METHODS METHODS
PGA sheets were applied on post-ESD ulcers with and against gravity six times each using the conventional and envelope methods, respectively. The PGA sheet delivery time and the endoscopic and histological findings of the treated ulcer floors were compared.
RESULTS RESULTS
With gravity, the median PGA sheet application time was 1.00 (0.68-1.30) min/cm2 and 0.32 (0.18-0.52) min/cm2 with the conventional and envelope techniques (p=0.002), respectively, and against gravity, it was 1.20 (1.13-1.63) min/cm2 and 0.50 (0.39-0.58) min/cm2 (p=0.002), respectively. Against gravity, the endoscopic and histological findings revealed that the conventional group had insufficient fixation of the PGA sheets, but the envelope groups had sufficient fixation. The results with gravity were similar between the groups.
CONCLUSION CONCLUSIONS
The envelope method makes it possible to deliver PGA sheets to the stomach quickly and cover ulcers appropriately both with and against gravity in living pigs.

Identifiants

pubmed: 32668527
pii: ce.2020.014
doi: 10.5946/ce.2020.014
pmc: PMC7939780
doi:

Types de publication

Journal Article

Langues

eng

Pagination

64-72

Subventions

Organisme : Kobe University
Organisme : KM Biologics Co., Ltd

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Auteurs

Hiroya Sakaguchi (H)

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Toshitatsu Takao (T)

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Yoshitaka Takegawa (Y)

KM Biologics Co., Ltd., Kumamoto, Japan.

Yuki Koga (Y)

KM Biologics Co., Ltd., Kumamoto, Japan.

Kazunori Yamanaka (K)

KM Biologics Co., Ltd., Kumamoto, Japan.

Masataka Sagata (M)

KM Biologics Co., Ltd., Kumamoto, Japan.

Shinwa Tanaka (S)

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Yoshinori Morita (Y)

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Takashi Toyonaga (T)

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Yuzo Kodama (Y)

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Classifications MeSH