Innovative submucosal injection solution for endoscopic resection with phosphorylated pullulan: A preclinical study.
endoscopic mucosal resection
endoscopic resection
endoscopic submucosal dissection
phosphorylated pullulan
submucosal injection
Journal
Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505
Informations de publication
Date de publication:
13 Jan 2024
13 Jan 2024
Historique:
received:
21
11
2023
revised:
25
12
2023
accepted:
10
01
2024
medline:
16
1
2024
pubmed:
16
1
2024
entrez:
15
1
2024
Statut:
aheadofprint
Résumé
The submucosal injection solution is used to assist in endoscopic surgery. The high viscosity of current solutions makes it difficult to inject. In the present study, we developed an extremely low-viscosity, easy-to-use submucosal injection solution using phosphorylated pullulan (PPL). The PPL solutions were prepared at different concentrations, and their viscosity was measured. The mucosal elevation capacity was evaluated using excised porcine stomachs. Controls included 0.4% sodium hyaluronate (SH), 0.6% sodium alginate (SA), and saline. To evaluate the practicality, the catheter injectability of 0.7% PPL was measured, and endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) were performed using the stomach and colorectum of live pigs. As controls, 0.4% SH and saline were used. The PPL solutions were of extremely low viscosity compared to those of 0.4% SH and 0.6% SA. Nevertheless, the mucosal elevation capacity of PPL solutions for up to 0.7% concentration was similar to that of 0.4% SH, and 0.7% PPL was less resistant to catheter infusion than 0.4% SH and 0.6% SA. In live pig experiments with EMR and ESD, snaring after submucosal injection of 0.7 % PPL was easier than with 0.4% SH, and ESD with 0.7% PPL produced less bubble formation than with 0.4% SH, and the procedure time tended to be shorter with 0.7% PPL than with 0.4% SH because of the shorter injection time. The PPL solution is an innovative and easy-to-use submucosal injection solution.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
The submucosal injection solution is used to assist in endoscopic surgery. The high viscosity of current solutions makes it difficult to inject. In the present study, we developed an extremely low-viscosity, easy-to-use submucosal injection solution using phosphorylated pullulan (PPL).
METHODS
METHODS
The PPL solutions were prepared at different concentrations, and their viscosity was measured. The mucosal elevation capacity was evaluated using excised porcine stomachs. Controls included 0.4% sodium hyaluronate (SH), 0.6% sodium alginate (SA), and saline. To evaluate the practicality, the catheter injectability of 0.7% PPL was measured, and endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) were performed using the stomach and colorectum of live pigs. As controls, 0.4% SH and saline were used.
RESULTS
RESULTS
The PPL solutions were of extremely low viscosity compared to those of 0.4% SH and 0.6% SA. Nevertheless, the mucosal elevation capacity of PPL solutions for up to 0.7% concentration was similar to that of 0.4% SH, and 0.7% PPL was less resistant to catheter infusion than 0.4% SH and 0.6% SA. In live pig experiments with EMR and ESD, snaring after submucosal injection of 0.7 % PPL was easier than with 0.4% SH, and ESD with 0.7% PPL produced less bubble formation than with 0.4% SH, and the procedure time tended to be shorter with 0.7% PPL than with 0.4% SH because of the shorter injection time.
CONCLUSIONS
CONCLUSIONS
The PPL solution is an innovative and easy-to-use submucosal injection solution.
Identifiants
pubmed: 38224821
pii: S0016-5107(24)00020-8
doi: 10.1016/j.gie.2024.01.015
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.