A novel method of endoscopic mucosal resection using sodium hyaluronate

Yamamoto, Hironori; Tomizo, Yube; Isoda, Yukihiro; Sato, Yukihiro; Sugita, Y.; Higashizawa, Toshihiko; Ido, Kenichi; Kimura, Ken; Kanai, Nobuyuki

doi:10.1016/s0016-5107(99)70234-8

Cited by 260 publications

(167 citation statements)

References 9 publications

Supporting

Mentioning

163

Contrasting

Unclassified

Order By: Relevance

“…Improvements in endoscopic resection techniques determined good results regarding local cure and long-term outcome after resection (25) . A predictable SFC is essential for safe EMR.…”

Section: Recently Various Emr Devices Have Been V 47 -No2 -Abr/jumentioning

confidence: 99%

“…A long-lasting SFC is necessary in lengthy procedures or in piecemeal resection of large sessile polyps. Many solutions have been tested for submucosal injection during EMR (2,3,7,13,19,21,23,24,25,26) . Recently, solutions with high viscosity, such as sodium hyaluronate (SH), hydroxypropyl methylcellulose (HPMC) and fibrinogen have been used.…”

Section: Introductionmentioning

confidence: 99%

“…Although the duration of mucosal elevation has improved, the ideal solution has not been founded yet (8) . SH is reported to create longer lasting SFCs (4,5,6,25) . However, it is expensive, needs specific storage requirements and has to be manipulated before There are no identifiable conflicts of interested (financial or otherwise) related to products mentioned in this article.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model

Lenz

Sena

Nakao

et al. 2010

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -Endoscopic mucosal resection is an established modality for excision of sessile lesions in the gastrointestinal tract. Submucosal fluid injection creates a cushion and may prevent thermal injury and perforation. Objectives -This blind study investigated the performance of three different solutions to create submucosal fluid cushions in porcine stomach. Methods -Three solutions were injected in the stomach of nine pigs BR1: normal saline solution, carboxymethylcellulose 0.5% and hydroxypropyl methylcellulose 0.25%. In each pig, submucosal injections with 6 mL per test-solution were performed. One drop of methylene blue was added to all injections for better visualization. The time for the bleb to disappear was recorded. Results -The overall median time of visible submucosal cushion was 37 minutes (range 12-60 min) for hydroxypropyl methylcellulose, 31 minutes for carboxymethylcellulose (range 10-43 min) and 19 minutes for normal saline solution (range 8-37 min). There was no statistically significant difference neither between normal saline solution and carboxymethylcellulose (P = 0.146) nor carboxymethylcellulose and hydroxypropyl methylcellulose (P = 0.119) but the median duration of hydroxypropyl methylcellulose was significantly longer than normal saline solution (P = 0.039). Conclusions -The length of hydroxypropyl methylcellulose submucosal fluid cushion is longer in comparison with normal saline solution. The median time for carboxymethylcellulose was not longer than normal saline solution. Hydroxypropyl methylcellulose, in the concentration of 0.25%, may be a durable alternative for submucosal injection.

show abstract

“…Improvements in endoscopic resection techniques determined good results regarding local cure and long-term outcome after resection (25) . A predictable SFC is essential for safe EMR.…”

Section: Recently Various Emr Devices Have Been V 47 -No2 -Abr/jumentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model

Lenz

Sena

Nakao

et al. 2010

Arq. Gastroenterol.

View full text Add to dashboard Cite

show abstract

“…This technique involves the use of an electrocautery knife to dissect out mucosal lesions. Several knives have been developed for ESD, including triangle-tip knives, hook knives, insulation-tip knives, and flex knives [32][33][34] . In ESD with use of a triangle-tip knife, the borders of a mucosal lesion are marked by electrocautery and then injection of an epinephrine-saline solution into the submucosa is performed.…”

Section: Endoscopic Submucosal Dissection (Esd)mentioning

confidence: 99%

Endoscopic mucosal resection in the upper gastrointestinal tract

Ahmadi¹,

Draganov²

2008

WJG

View full text Add to dashboard Cite

Endoscopic mucosal resection (EMR) is a technique used to locally excise lesions confined to the mucosa. Its main role is the treatment of advanced dysplasia and early gastrointestinal cancers. EMR was originally described as a therapy for early gastric cancer. Recently its use has expanded as a therapeutic option for ampullary masses, colorectal cancer, and large colorectal polyps. In the Western world, the predominant indication for EMR in the upper gastrointestinal tract is the staging and treatment of advance dysplasia and early neoplasia in Barrett's esophagus. This review will describe the basis, indications, techniques, and complications of EMR, and its role in the management of Barrett's esophagus.

show abstract

“…A major breakthrough was achieved at the turn of the twenty-first century, with the advent of endoscopic submucosal dissection (ESD) [14][15][16][17][18][19][20]. ESD is a technique developed to enable the resection of large and ulcerative lesions, regardless of tumor location, that are unable to be removed using the conventional EMR procedure.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of a strategy involving endoscopic submucosal dissection for early gastric cancer: determining the optimal pathway

et al. 2011

View full text Add to dashboard Cite

Background Endoscopic submucosal dissection (ESD) is a technique developed to enable the endoscopic resection (ER) of large and ulcerative neoplastic lesions that were previously unresectable using conventional endoscopic mucosal resection (EMR). We investigated the clinical outcomes of ER of early gastric cancer (EGC) before and after the introduction of ESD, with particular attention to surgery and its potential consequences. Methods We reviewed 2,785 consecutive surgical patients with EGC and 2,469 consecutive lesions treated by ER with curative intent between 1990 and 2005. The study was divided into an EMR period (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999) and an ESD period (2000)(2001)(2002)(2003)(2004)(2005). We analyzed the clinical outcomes of endoscopic and surgical resections and defined 'potentially avoidable surgery' as cases of surgery performed for lesions curable by ER. Results The rate of potentially avoidable surgery was 3.8% (52/1,369) in the EMR period and 0.2% (3/1,416) in the ESD period (P \ 0.001). For ER patients, the rate of overall non-curative ER was 36.9% (154/417) in the EMR group and 17.0% (348/2,052) in the ESD group (P \ 0.001). The rate of non-curative ER for lesions defined as having 'positive or difficult to estimate horizontal margins only' decreased significantly, from 26.1% (109/417) in the EMR group to 1.4% (29/2,052) in the ESD group (P \ 0.001). Conversely, the rate of non-curative ER for lesions defined as having 'possible lymph node metastasis' significantly increased in the ESD group (15.5%; 319/2,052) compared to that in the EMR group (10.8%; 45/417) (P \ 0.01). Conclusions The application of a pathway involving ESD resulted in a significant decrease in the rate of potentially avoidable surgery, highlighting the advantages associated with performing ESD.

show abstract

A novel method of endoscopic mucosal resection using sodium hyaluronate

Cited by 260 publications

References 9 publications

Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model

Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model

Endoscopic mucosal resection in the upper gastrointestinal tract

Clinical impact of a strategy involving endoscopic submucosal dissection for early gastric cancer: determining the optimal pathway

Contact Info

Product

Resources

About