A novel method of endoscopic mucosal resection using sodium hyaluronate

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Saline-assisted endoscopic mucosal resection (EMR) is a standard procedure.
• Maintaining adequate tissue elevation with saline can be challenging.
• Investigating alternative submucosal injectates is crucial for improving EMR outcomes.

Purpose of the Study:

• To evaluate the efficacy of sodium hyaluronate as a submucosal injectate for EMR.
• To compare the duration and quality of mucosal elevation achieved with sodium hyaluronate versus saline.
• To assess the safety and reliability of sodium hyaluronate-assisted EMR.

Main Methods:

• Ex vivo study using porcine stomachs and in vivo study using dogs.
• Submucosal injections of sodium hyaluronate and normal saline were administered to create mucosal elevations.
• Comparison of mucosal elevation characteristics and performance of EMR procedures between sodium hyaluronate and saline groups.

Main Results:

• Sodium hyaluronate injections resulted in longer-lasting mucosal elevations with clearer margins compared to saline.
• Endoscopic mucosal resections were successfully and safely performed using sodium hyaluronate as an adjunct.
• The improved elevation facilitated a more controlled and effective resection process.

Conclusions:

• Sodium hyaluronate is a superior alternative to saline for submucosal injection in EMR.
• Utilizing sodium hyaluronate can enhance the ease and reliability of endoscopic mucosal resection.
• This finding suggests a potential improvement in EMR technique and patient outcomes.