Evaluation of dextrose 50 % as a medium for injection-assisted polypectomy

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Technology

Background:

• Traditional injection-assisted polypectomy (IAP) uses normal saline, which offers limited submucosal cushion duration.
• Hypertonic solutions like dextrose 50% were hypothesized to provide superior submucosal elevation for IAP.

Purpose of the Study:

• To evaluate the efficacy and safety of dextrose 50% as a submucosal fluid cushion for IAP.
• To compare dextrose 50% with normal saline in terms of procedural efficiency and resection outcomes.

Main Methods:

• A prospective, randomized, blinded study comparing normal saline and dextrose 50% for IAP during gastroscopy and colonoscopy.
• Key metrics included volume and number of injections, need for re-injection, en bloc and complete resection rates, and complication rates.

Main Results:

• Dextrose 50% required smaller volumes (median 5 ml vs. 7 ml) and fewer injections (median 1 vs. 2) for effective submucosal elevation.
• En bloc resection rates were significantly higher with dextrose 50% (82% vs. 44%).
• Submucosal elevation persisted post-procedure in 96% of dextrose 50% cases versus 20% for normal saline.

Conclusions:

• Dextrose 50% is a superior submucosal fluid cushion for IAP compared to normal saline.
• Its use enhances en bloc resection rates and provides sustained submucosal elevation during endoscopic mucosal resection procedures.