Efficacy and Safety of a Novel Submucosal Injection Solution for Resection of Gastrointestinal Lesions
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AuthorMoles Aranda, Cristina; Clares Naveros, Beatriz; González Pérez, Raquel; Martínez Augustín, María Olga; Sánchez De Medina López-Huertas, Fermín; Morales-Molina, José Antonio
EfficacySafetyEndoscopic submucosal dissectionEndoscopic mucosal resectionGastrointestinal endoscopySubmucosal injection
Moles-Aranda, C., González-Pérez, R., Gallego-Rojo, F. J., Martínez-Augustin, O., Clares-Naveros, B., Sánchez de Medina, F., & Morales-Molina, J. A. (2020). Efficacy and Safety of a Novel Submucosal Injection Solution for Resection of Gastrointestinal Lesions. Journal of Clinical Medicine, 9(4), 1162. [doi:10.3390/jcm9041162]
SponsorshipStudy co-financed by the Junta de Andalucia (PIN-0479-2016, CTS676, CTS235, CTS164), the Ministry of Economy and Competitivity, Spain (SAF2017-88457-R, AGL2017-85270-R), Nakafarma S.L and CIBERehd is funded by Instituto de Salud Carlos III, Spain. The sponsors had no role in the design, execution, interpretation, or writing of the study.
Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are minimally invasive and efficient techniques for the removal of gastrointestinal (GI) mucosal polyps. In both techniques, submucosal injection solutions are necessary for complete effectiveness and safety during the intervention to be obtained. The main objective of this study was to evaluate the efficacy and safety of a new sterile submucosal injection solution for EMR/ESD used within a clinical protocol in patients with intestinal polyps. We carried out a prospective study between 2016 and 2017 with patients who attended the Endoscopy Consultation—Digestive Department of Primary Hospital. Patients were selected for EMR/ESD after the application of clinical protocols. Thirty-six patients were selected (≥ 66 years with comorbidities and risk factors). Lesions were located mainly in the colon. Our solution presented an intestinal lift ≥ 60 min in EMR/ESD and a high expansion of tissue, optimum viscosity, and subsequent complete resorption. The genes S100A9 and TP53 presented an expression increase in the distal regions. TP53 and PCNA were the only genes whose expression was increased in polyp specimens vs. the surrounding tissue at the mRNA level. In EMR/ESD, our solution presented a prolonged effect at the intestinal level during all times of the intervention. Thus, our solution seems be an effective and safe alternative in cases of flat lesions in both techniques.