Submucosal injection of normal saline may prevent tissue damage from argon plasma coagulation: an experimental study using resected porcine esophagus, stomach, and colon.
Argon plasma coagulation (APC) is considered to be a safe thermocoagulation technique, but some reports show perforation and deformity during and after APC. In this study, we investigated the usefulness of prior submucosal injection for APC. APC over the mucosa was performed on fresh resected porcine esophagus, stomach, and colon with prior submucosal injection of normal saline (injection group) and without it (control group). The depth of tissue damage increased linearly with pulse duration up to the shallower submucosal layer in both groups. After that, tissue damage in the injection group remained confined to the shallower submucosal layer under any condition, whereas that in the control group continued to extend. The tissue damages of the injection groups were significantly (P<0.05) shallower than those of the control groups that reached the deeper submucosal layer in all the organs. Submucosal injection of normal saline before the application of APC may limit tissue damage and prevent perforation and deformity.
Fujishiro
Mitsuhiro
M
Department of Gastroenterology, Graduate school of Medicine, University of Tokyo, Tokyo, Japan. mtfujish-kkr@umin.ac.jp
Yahagi
Naohisa
N
Nakamura
Masanori
M
Kakushima
Naomi
N
Kodashima
Shinya
S
Ono
Satoshi
S
Kobayashi
Katsuya
K
Hashimoto
Takuhei
T
Yamamichi
Nobutake
N
Tateishi
Ayako
A
Shimizu
Yasuhito
Y
Oka
Masashi
M
Ichinose
Masao
M
Omata
Masao
M
D000818:Animals; D001128:Argon; D003106:Colon / Q000473:pathology; D004564:Electrocoagulation / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal; D004947:Esophagus / Q000473:pathology; D005753:Gastric Mucosa / Q000473:pathology; D007267:Injections; D007413:Intestinal Mucosa / Q000473:pathology; D009092:Mucous Membrane / Q000473:pathology; D012965:Sodium Chloride / Q000008:administration & dosage*; D013552:Swine
D012965:Sodium Chloride; D001128:Argon