title: A randomised study of hydro-jet vs. needle injection for lifting colorectal lesions prior to endoscopic resection.
abstract: BACKGROUND
  Submucosal lifting of lesions prior to endoscopic resection is crucial to reduce complications and improve the technical feasibility of the procedure.
  
  
  OBJECTIVE
  To compare a self-assembled hydro-jet system vs. standard needle injection for tissue elevation prior to endoscopic resection of colorectal lesions.
  
  
  METHODS
  Randomised study performed at a single tertiary care institution. Consecutive patients with colonoscopic diagnosis of sessile polyps or non-polypoid lesions >5 mm or laterally spreading tumours.
  
  
  METHODS
  successful elevation, time to proper elevation, completeness of excision, cautery damage, and general histological diagnostic quality (blinded pathologic assessment).
  
  
  RESULTS
  79 patients were randomised to hydro-jet (40 patients, group A) and needle (39 patients, group B) elevation. Successful elevation was achieved in 97.5% and 94.8%, respectively. Time to proper elevation was 8+/-5 s vs. 18+/-3 s (p<0.05). In group A, histology showed selective accumulation of fluid in the submucosa with intact collagen fibres. Damage to muscularis mucosa was never noted in the specimens of group A and in 7 cases of group B (p<0.01). Artefacts from "cautery effect" were very limited. Radial margins of resection could be adequately evaluated in all cases and were negative.
  
  
  CONCLUSIONS
  The hydro-jet system is as effective and safe as standard needle injection for tissue elevation prior to endoscopic resection of colorectal lesions, but it is significantly faster.
authors: Division of Gastroenterology-Hospital "A. Maresca", Torre del Greco, Italy. livio.cipolletta@alice.it
authors: L
authors: L
authors: Cipolletta
authors: M A
authors: MA
authors: Bianco
authors: M L
authors: ML
authors: Garofano
authors: C
authors: C
authors: Meucci
authors: R
authors: R
authors: Piscopo
authors: F
authors: F
authors: Cipolletta
authors: R
authors: R
authors: Salerno
authors: S
authors: S
authors: Sansone
authors: G
authors: G
authors: Rotondano
mesh_terms: D055011:Ablation Techniques / Q000295:instrumentation* / Q000379:methods; D000368:Aged; D001706:Biopsy / Q000295:instrumentation; D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000601:surgery*