Impedance-Modified Injection Solutions in Endoscopic Removal of Gastrointestinal Lesions: A Randomized Controlled Trial

Abstract

Background: The efficiency of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) is related to the electrical impedance of the injection solutions. It is therefore possible to postulate that improving impedance may enhance resection rates while minimizing the risks. Objective: To assess the effectiveness and the side effects of impedance-modified injection solutions in the endoscopic resection of gastrointestinal lesions. Methods: This study was a randomized controlled trial of patients with gastrointestinal lesions greater than 20mm in size The patients were randomly assigned to receive standard saline solution or an impedance-modified injection solution during EMR/ESD. The first end-point of the study was the en-bloc resection rate. Other related measures were procedure duration, complication profiles, and histological characteristics. Data were analyzed using SPSS version 27.0 and statistical significance was set at p≤0.05. Results: The impedance-modified group had a statistically higher en-bloc resection rate as compared to the standard saline group at 85 percent against 65 percent respectively, p<0.05 The procedure taking times were less in the impedance-modified group and complication rates are also less though not reaching the statistical difference. Conclusion: The enhancement of EMR/ESD by using impedance-modified injection solutions indicates new direction in endoscopic practice.