alexa Evaluation of the Optimal Injection Solution in Hybrid Endoscopic Submucosal Dissection (ESD) for Various Organs in an Ex Vivo Porcine Model
ISSN: 2161-069X

Journal of Gastrointestinal & Digestive System
Open Access

Like us on:
OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Article

Evaluation of the Optimal Injection Solution in Hybrid Endoscopic Submucosal Dissection (ESD) for Various Organs in an Ex Vivo Porcine Model

Yuta Nakagawa, Kenshi Matsumoto*, Akihito Nagahara, Tsutomu Takeda, Kohei Matsumoto, Hiroya Ueyama, Yuji Shimada, Daisuke Asaoka, Mariko Hojo and Sumio Watanabe

Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan

*Corresponding Author:
Kenshi Matsumoto
Department of Gastroenterology
Juntendo University School of Medicine
2-1-1 Hongo, Bunkyo-Ku
Tokyo 113-8421, Japan
Tel: 81-3-3813-3111
Fax: +81-3-3813-8862
E-mail: [email protected]

Received date: December 06, 2015 Accepted date: December 21, 2015 Published date: December 28, 2015

Citation: Nakagawa Y, Matsumoto K, Nagahara A, Takeda T, Matsumoto K et al. (2015) Evaluation of the Optimal Injection Solution in Hybrid Endoscopic Submucosal Dissection (ESD) for Various Organs in an Ex Vivo Porcine Model. J Gastrointest Dig Syst 5:366. doi: 10.4172/2161-069X.1000366

Copyright: © 2015 Nakagawa Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Background: For flat and/or depressed lesions ranging from 11-20 mm, hybrid ESD, i.e., EMR with circumferential incision (CI), is now prevalent. However, there is no clear standard for choosing an injection solution. Sodium hyaluronate (SH) is often used, despite its disadvantages. This study aimed to clarify the most effective injection solution for safe hybrid ESD for trainees in various gastrointestinal tract organs.

Methods: CI was performed on 30 resected porcine esophagi, stomachs, duodena and colons. The following three solutions were injected into submucosa, and their ability to maintain mucosal elevation height (MEH) was evaluated: Solution A, normal saline (NS); Solution B, 1:1 mixture of NS and 0.4% SH; and Solution C, 0.4% SH. We measured the minimum snarable MEH and the average procedure time for snaring, and the optimal concentration of SH was identified both graphically and histopathologically.

Results: The lesion-lift ability was superior at higher SH concentrations except, for duodenum. No solution obtained sufficient MEH in duodenum. The minimum snarable MEH was 5.02 mm, 5.73 mm, and 6.05 mm, and the snaring procedure time was 58.8 s, 56.2 s, and 75.3 s in esophagus, stomach, and colon, respectively. Hybrid ESD could be performed successfully with Solution B for esophagus, Solution A for stomach and Solution C for colon, and these results were confirmed histopathologically.

Conclusions: The optimal solutions for hybrid ESD in an ex-vivo porcine model for trainees were Solution B for esophagus, Solution A for stomach, and Solution C for colon. Further study is needed for duodenum.


Share This Page

Additional Info

Loading Please wait..
Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version