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Endoscopic mucosal resection with 0.13% hyaluronic acid solution for colorectal polyps less than 20 mm: a randomized controlled trial.
- Source :
-
Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2012 Aug; Vol. 27 (8), pp. 1377-83. - Publication Year :
- 2012
-
Abstract
- Background and Aim: Adequate mucosal elevation by submucosal injection is important for definitive en bloc resection and prevention of perforation during endoscopic mucosal resection (EMR). The objective of this study is to determine the efficacy of 0.13% hyaluronic acid (HA) solution for high and sustained mucosal elevation during colorectal EMR.<br />Methods: The study was a prospective randomized controlled trial; a total of 196 patients with colon polyps of < 20 mm diameter were enrolled and randomized in a 1:1 ratio to undergo EMR using either 0.13% HA or normal saline (NS). The primary outcome of the study was histopathologically confirmed complete resection. The secondary outcomes such as maintenance of high mucosal elevation and development of complications were also evaluated. Moreover, the relationship between complete resection and the experience of the endoscopist (veteran vs less experienced) was analyzed.<br />Results: Compete resection was achieved in 74 of 93 polyps (79.5%) in the 0.13% HA group and 63 of 96 polyps (65.6%) in the NS group (P < 0.05). High mucosal elevation was maintained in 83.9% of procedures in the 0.13% HA group and 54.1% in the NS group (P < 0.01). The frequency of complete resection achieved by less-experienced endoscopists was higher in the 0.13% HA group (79.3%) than in the NS group (62.1%; P < 0.05).<br />Conclusions: Endoscopic mucosal resection using 0.13% HA to colon polyps of less than 20 mm diameter is more effective than NS for complete resection and maintenance of mucosal elevation.<br /> (© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Clinical Competence
Colonic Polyps pathology
Female
Humans
Hyaluronic Acid adverse effects
Injections
Japan
Male
Middle Aged
Polyps pathology
Prospective Studies
Rectal Diseases pathology
Sodium Chloride adverse effects
Treatment Outcome
Young Adult
Colonic Polyps surgery
Colonoscopy adverse effects
Hyaluronic Acid administration & dosage
Intestinal Mucosa surgery
Polyps surgery
Rectal Diseases surgery
Sodium Chloride administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1746
- Volume :
- 27
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology and hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 22554102
- Full Text :
- https://doi.org/10.1111/j.1440-1746.2012.07166.x