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Innovative submucosal injection solution for endoscopic resection with phosphorylated pullulan: a preclinical study
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DOI：10.1016/j.gie.2024.01.015.png)
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Abstract
En 中文
Background and Aims: A submucosal injection solution is used to assist in endoscopic surgery. The high vis-cosity of current solutions makes them difficult to inject. In the present study, we developed an extremely low-viscosity, easy-to-use submucosal injection solution using phosphorylated pullulan (PPL). Methods: The PPL solutions were prepared at different concentrations, and their viscosities were 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 EMR and endoscopic submucosal dissection (ESD) were performed using the stomachand colorectum of live pigs. As controls, 0.4% SH and saline were used. Results: The PPL solutions were of extremely low viscosity compared to the solutions 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 of0.4% SH, and 0.7% PPL was less resistant to catheter infusion than 0.4% SH and 0.6% SA. In live pig experiments with endoscopic mucosal resection and ESD, snaring after submucosal injection of 0.7% PPL was easier than with0.4% SH, 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:The PPL solution is an innovative and easy-to-use submucosal injection solution.
Keywords:
SODIUM HYALURONATE
DISSECTION
ALGINATE
SAFETY
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