Novel submucosal injection solution 0.6% sodium alginate: Bench to market for endoscopic submucosal dissection optimization

Kawaguchi, Koichiro; Isomoto, Hajime

doi:10.1111/den.13426

Cited by 8 publications

(8 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Endoscopic treatments such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are the most effective treatments in early-stage gastrointestinal neoplasms. − The development of high-performance submucosal injection materials (SIMs) significantly contributes to the advancement of rapid and safe endoscopic treatments. ,, High-performance SIMs currently used in endoscopic treatments include sodium hyaluronate (HA), sodium alginate, hydroxypropyl methylcellulose, and other similar materials − that are viscous solutions . In addition, to surpass the performance of current SIMs, various materials have been produced − and their effectiveness as SIMs has been examined; these include shear-thinning hydrogels, biodegradable hydrogels, drug-eluting elastomeric polymers, and reverse-phase polymers.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development of Sodium Polyacrylate-Based High-Performance Submucosal Injection Material with Pseudoplastic Fluid Characteristics

Hirose

Yoshida

Naito

et al. 2019

ACS Biomater. Sci. Eng.

View full text Add to dashboard Cite

The development of high-performance submucosal injection materials (SIMs) has significantly contributed to the advancement of rapid and safe endoscopic submucosal dissection (ESD). A previous study authored by us described that pseudoplastic fluid was more suitable for high-performance SIMs than Newtonian fluid. Herein, a novel high-performance SIM is developed, which is primarily composed of sodium polyacrylate (SPA) and exhibits pseudoplastic fluid characteristics. As a representative of current high-performance SIMs with Newtonian fluid characteristics, 0.4% sodium hyaluronate (HA) was selected as the target for comparison. Further, viscoelasticity, submucosal elevation height (SEH), and injection pressure (IP) of HA and SPA were evaluated. The results obtained by ESD were compared using HA or SPA in an ex vivo model. According to the measured viscoelasticity, the concentration of SPA was adjusted to 0.07%; this was aimed at obtaining the IP of SPA, which is equal to that of 0.4% HA. Moreover, no significant difference was observed between the IP values (31.6 ± 1.7 vs 31.4 ± 3.1 psi). SEHs of 0.07% SPA were higher than those of 0.4% HA at all postinjection times (P < 0.001). The duration of the ESD procedure using 0.07% SPA was significantly shorter than that obtained using 0.4% HA (16.6 ± 3.7 vs 22.2 ± 2.9 min, P = 0.0276); further, the total volume of the injected 0.07% SPA was significantly less than that of 0.4% HA (9.0 ± 3.1 vs 15.7 ± 3.9 mL, P = 0.0165). Based on rheological analysis, a high-performance SIM (0.07% SPA) with pseudoplastic fluid characteristics was theoretically developed. It was observed that the SIM performance of 0.07% SPA was higher than that of 0.4% HA.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Currently employed SIMs such as HA, sodium alginate, and hydroxypropyl methylcellulose are Newtonian fluids. − ,, Therefore, from a rheological viewpoint, the development of SIMs with pseudoplastic fluid characteristics can lead to the fabrication of SIMs having a better performance than the currently used SIMs.…”

Section: Introductionmentioning

confidence: 99%

Development of Sodium Polyacrylate-Based High-Performance Submucosal Injection Material with Pseudoplastic Fluid Characteristics

Hirose

Yoshida

Naito

et al. 2019

ACS Biomater. Sci. Eng.

View full text Add to dashboard Cite

show abstract

“…Hyaluronic acid has been one of the most commonly used and reliable viscous solutions in the ESD procedure [30]. Recently, the usefulness of sodium alginate in the ESD procedure has been reported in Japan [31,32]. Furthermore, other viscous solutions have been explored to improve the ESD procedure in other (especially Western) countries [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study

et al. 2019

View full text Add to dashboard Cite

Background: Endoscopic submucosal dissection (ESD) is a standard treatment for tumors of the gastrointestinal tract. We developed a self-completion method of ESD using Endosaber to eliminate the need for an additional device or human assistance during the procedure. The aim of this study was to evaluate the technical feasibility and outcomes of this method in an ex vivo porcine training model. Methods: This was a pilot study, and the procedures were performed by 4 experts. Mock lesions measuring 15 mm in diameter were prepared at the posterior wall in the middle or lower esophagus obtained from domestic pigs. Each operator performed ESD on the mock lesions in 3 models. The primary outcome was ESD completion rate using the self-completion method. The secondary outcomes were procedure time, en bloc resection rate, perforation rate, and number of injections during the procedure. Results: All 12 ESDs were completed using the self-completion method. The median procedure time (interquartile range) was 483.5 (399–619.3) s (median incision time: 240.4 [168.3–332.5] s; median dissection time: 222 [182.8–257] s). En bloc resection rate was 100%. No perforation was noted during any of the procedures. The median number of injections was 10.5 (9–14.3). The procedure time decreased significantly with increase in experience (p = 0.020). Conclusions: The self-completion ESD method using one Endosaber without any assistance achieved a 100% en bloc resection rate without any perforation. The need for an additional device or assistance was successfully eliminated. This method may prove to be a simple and cost-effective ESD procedure for lesions in humans.

show abstract

“…The first inhuman application for gastric ESD was uneventfully conducted using various concentrations of SA eventually set at 0.6% of SA. 2 Uemura et al designed a multicenter randomized controlled trial and it has received an approval from the Ministry of Health, Labour, and Welfare of Japan for the marketing of medical devices and drugs, this study was registered with Pharmaceuticals and Medical Devices Agency. 3 Thus, on-label use of this drug would allow popularization in clinical practice in ESD through historical Japan Gastroenterological Endoscopy Society contribution and under ideal concept of the membership, that is a fruit of academic-industrial collaboration, highlighting the significance of preclinical animal studies using relative macrofauna or ex vivo simulation settings.…”

Section: Experimental and Translational Research In Endoscopic Submuc...mentioning

confidence: 99%

“…The ex vivo study showed equivalent thickness of the submucosal cushion with SA compared to sodium hyaluronate in the porcine stomach. The first in‐human application for gastric ESD was uneventfully conducted using various concentrations of SA eventually set at 0.6% of SA 2 . Uemura et al .…”

Section: Experimental and Translational Research In Endoscopic Submuc...mentioning

confidence: 99%

Experimental and translational research in gastrointestinal endoscopy, the Japan Gastroenterological Endoscopy Society and perspective

Isomoto

Suzuki

2021

Digestive Endoscopy

Self Cite

View full text Add to dashboard Cite

Novel submucosal injection solution 0.6% sodium alginate: Bench to market for endoscopic submucosal dissection optimization

Abstract: This Editorial refers to the article by N. Uemura et al., p 396–404 of this issue.

Cited by 8 publications

References 10 publications

Development of Sodium Polyacrylate-Based High-Performance Submucosal Injection Material with Pseudoplastic Fluid Characteristics

Development of Sodium Polyacrylate-Based High-Performance Submucosal Injection Material with Pseudoplastic Fluid Characteristics

Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study

Experimental and translational research in gastrointestinal endoscopy, the Japan Gastroenterological Endoscopy Society and perspective

Contact Info

Product

Resources

About