The Efficacy and Diagnostic Significance of Sodium Thiosulphate Solution Spraying After Iodine Dyeing of the Esophagus

Abstract

Spraying with Sodium Thiosulphate Solution (STSS, Detoxol®) is reported to be useful in reducing the side effects of Iodine dyeing on the esophagus. In order to determine the optimal concentration of STSS and its efficacy, STSS was administered in the following concentrations. Group A: 10% (Original Solution), Group: B 5%. Group C, 2.5%. Group D: 1.7% and Group E: saline with no STSS, and a questionnaire was conducted to assess the side effects. The results showed that the higher the concentration, the less frequent and short lasting the side effects were. The effects of STSS on diagnostic efficacy was also evaluated. After spraying with STSS, the 2.5% solution removed iodine gradually but there were differences in discoloration among the various degrees of inflammation. When iodine dyeing was repeated, clear images with a good contrast were obtained. Excess iodine was neutralized and details of the surface and vascular pattern were more readily observed. Spraying with STSS seemed to increase the diagnostic ability of the procedure.

Evaluation of visualization of squamous cell carcinoma of esophagus and pharynx using an autofluorescence imaging videoendoscope system

“…The early detection of superficial SCC of the esophagus by conventional WLE continues to be difficult 5,7 because there are few morphological changes, but LC improves the endoscopic visualization and frequently makes it possible to diagnose esophageal SCC at an early stage. [7][8][9] Unfortunately, Lugol staining often causes mucosal irritation during examinations leading to retrosternal pain and discomfort, [10][11][12][13][14] although final rinsing with thiosulfate solution can ease such irritation. Despite the fact that gastrointestinal endoscopists now have a better chance of finding pharyngeal cancers, the majority are not detected until an advanced stage with a resultant poor prognosis because it is so difficult to detect such lesions using conventional WLE.…”

“…The early detection of superficial SCC of the esophagus by conventional WLE continues to be difficult 5,7 because there are few morphological changes, but LC improves the endoscopic visualization and frequently makes it possible to diagnose esophageal SCC at an early stage 7–9 . Unfortunately, Lugol staining often causes mucosal irritation during examinations leading to retrosternal pain and discomfort, 10–14 although final rinsing with thiosulfate solution can ease such irritation.…”

“…In order to detect esophageal SCC at an early stage, Lugol chromoendoscopy (LC) has been widely used in high‐risk populations, resulting in a dramatic increase in the number of superficial SCC detected 7–9 . Adverse effects such as retrosternal pain and discomfort, however, often occur because of the mucosal irritation caused by Lugol staining 10–14 …”

“…[7][8][9] Adverse effects such as retrosternal pain and discomfort, however, often occur because of the mucosal irritation caused by Lugol staining. [10][11][12][13][14] It is well known that patients with esophageal SCC often have synchronous and metachronous pharyngeal SCC. 15 The long-term outcome of patients after ER for esophageal SCC has been influenced to a greater extent by the existence of a second malignancy, particularly pharyngeal cancer, in addition to the initial esophageal cancer.…”

Ability of artificial intelligence to detect T1 esophageal squamous cell carcinoma from endoscopic videos: supportive effects of real-time assistance

“…Iodine staining can improve ESCC detection with high sensitivity and speci city; however, it can cause severe discomfort and increases the procedure time [5,6,7] . It is therefore used only for high-risk patients.…”