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Efficacy and Safety of a Novel Submucosal Injection Solution for Resection of Gastrointestinal Lesions.

ABSTRACT: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are minimally invasive and efficient techniques for the removal of gastrointestinal (GI) mucosal polyps. In both techniques, submucosal injection solutions are necessary for complete effectiveness and safety during the intervention to be obtained. The main objective of this study was to evaluate the efficacy and safety of a new sterile submucosal injection solution for EMR/ESD used within a clinical protocol in patients with intestinal polyps. We carried out a prospective study between 2016 and 2017 with patients who attended the Endoscopy Consultation-Digestive Department of Primary Hospital. Patients were selected for EMR/ESD after the application of clinical protocols. Thirty-six patients were selected (? 66 years with comorbidities and risk factors). Lesions were located mainly in the colon. Our solution presented an intestinal lift ? 60 min in EMR/ESD and a high expansion of tissue, optimum viscosity, and subsequent complete resorption. The genes S100A9 and TP53 presented an expression increase in the distal regions. TP53 and PCNA were the only genes whose expression was increased in polyp specimens vs. the surrounding tissue at the mRNA level. In EMR/ESD, our solution presented a prolonged effect at the intestinal level during all times of the intervention. Thus, our solution seems be an effective and safe alternative in cases of flat lesions in both techniques.

SUBMITTER: Moles-Aranda C

PROVIDER: S-EPMC7230585 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Efficacy and Safety of a Novel Submucosal Injection Solution for Resection of Gastrointestinal Lesions.

Moles-Aranda Cristina C González-Pérez Raquel R Gallego-Rojo Francisco Javier FJ Martínez-Augustin Olga O Clares-Naveros Beatriz B Sánchez de Medina Fermín F Morales-Molina José Antonio JA

Journal of clinical medicine 20200418 4

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are minimally invasive and efficient techniques for the removal of gastrointestinal (GI) mucosal polyps. In both techniques, submucosal injection solutions are necessary for complete effectiveness and safety during the intervention to be obtained. The main objective of this study was to evaluate the efficacy and safety of a new sterile submucosal injection solution for EMR/ESD used within a clinical protocol in patient ...[more]

PMID: 32325745

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Project description:Background Endoscopic mucosal dissection (EMD) is a new treatment method. Whether its clinical efficacy and safety are superior to surgical resection is still controversial. The sample size of previous studies on EMD for the treatment of early cancer of digestive tract is small, and there is no reliable evidence at present. Therefore, it is necessary to evaluate the efficacy and safety of EMD based on the evidence of evidence-based medicine. Methods The PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang, cqvip.com (VIP), websites and citation searching were searched to obtain relevant literature on EMD for early cancer and precancerous lesions of digestive tract. The retrieval time was from the establishment of the database to November 29th, 2022. Literature was screened according to inclusion and exclusion criteria and data and data were extracted. The final included literature was assessed by Cochrane risk of bias tool, and publication bias was assessed by Egger’s test. Results A total of 10 articles were included, with a total of 1,165 patients. Among these, 585 cases were treated with EMD and 580 cases were in the control group. The literature quality evaluation found that 5 articles had low risk of bias and 5 articles had unclear risk of bias. The results showed that the complete resection rate in the observation group was higher than that in the control group [risk ratio (RR) =1.25, 95% confidence interval (CI): 1.15–1.35, P<0.01]. Cumulative intraoperative blood loss (P<0.01), operation time (P<0.01), postoperative complications (P<0.01), hospital stay (P<0.01), and hospitalization expenses (P<0.01) in the observation group were lower than those in the control group. Conclusions EMD for early gastrointestinal cancer and precancerous lesions can improve the complete resection rate of tumors; reduce intraoperative blood loss, complications, operation time, and hospitalization time and cost. However, due to the small number of literatures included in this paper, the quality of literatures is not high, and some results have heterogeneous interference, the conclusion needs to include more high-treatment studies for further study.

Dataset Information

Efficacy and Safety of a Novel Submucosal Injection Solution for Resection of Gastrointestinal Lesions.

Publications

Efficacy and Safety of a Novel Submucosal Injection Solution for Resection of Gastrointestinal Lesions.

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