Premium
Physical effect of various submucosal elevation solutions for colorectal endoscopic procedure: Measuring the vertical‐to‐horizontal ratio
Author(s) -
Day Weida,
Saito Yutaka
Publication year - 2011
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2011.00548.x
Subject(s) - medicine , saline , endoscopic ultrasound , hyaluronic acid , endoscopic mucosal resection , endoscopic submucosal dissection , colorectal adenoma , gastroenterology , endoscopy , surgery , colorectal cancer , anatomy , cancer
Aim: Submucosal elevation solution is an essential element used in endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for colorectal lesions. Therefore, it is important to select a suitable solution for the endoscopic procedure. The aim of the present study was to examine the real time vertical‐to‐horizontal (V–H) ratio physical effect of submucosal elevation solution during colorectal EMR. Methods: This was a prospective randomized study carried out at an endoscopy centre in a Hong Kong hospital. A total of 10 patients with 15 colorectal adenoma requiring EMR were recruited. The studied submucosal elevation solutions included normal saline, glycerol and hyaluronic acid. Before EMR, 3 mL of these solutions were injected in the submucosal space, one solution at a time. The vertical and horizontal length of the elevated submucosal space was measured by miniprobe ultrasound. V–H ratios of different solutions were calculated and compared. Vertical distance, horizontal distance and V–H ratio of the submucosal space after injection of the submucosal elevation agents were measured. Results: The mean size of lesions was 14 mm (range 10–20). Glycerol and hyaluronic acid had a significant higher V–H ratio than normal saline; the V–H ratio of normal saline, glycerol and hyaluronic Acid were 0.29, 0.53 and 0.50, respectively. Limitations: The exact volume of the injection was not certain, and the time between the injection and endoscopic ultrasound assessment was variable. These limitations were overcome by calculating the V–H ratio. Conclusion: Glycerol and hyaluronic acid have a higher V–H ratio, which makes them good submucosal elevation solutions.