title: MESNA for chemically assisted tissue dissection.
abstract: BACKGROUND
  To date, surgical dissection is based only on mechanical forces. The use of a chemical product that is able to ease tissue dissection represents an important advance. MESNA (sodium-2-mercaptoethanesulfonate) has recently been validated for chemically assisted tissue dissection during surgery or invasive procedures. No other drugs are available for this.
  
  
  METHODS
  An extensive literature search was conducted that included published articles and abstracts on the use of MESNA during surgery or invasive procedures in the experimental and clinical setting, since 1997. Clinically validated settings are ear, nose and throat (ENT), gynecological and orthopedic fields.
  
  
  RESULTS
  A state-of-the-art overview of intraoperative applications of MESNA, and a consideration of the possible mechanisms underlying chemically assisted tissue dissection.
  
  
  CONCLUSIONS
  MESNA has been successfully used to ease abdominal myomectomies and excision of endometrial cysts; in ENT surgery, topical MESNA could be widely used, from ear and skull base to head and neck diseases, in both outpatient and operating-room settings. In revision lumbar spine surgery, its use resulted in significantly easier surgery and reduction of postoperative complications. Given the high efficacy and favorable complications rate, future applications in the surgical field are expected to increase.
authors.affiliation: University Campus Bio-Medico of Rome, Department of Otolaryngology, Rome, Italy.
authors.forename: Manuele
authors.initials: M
authors.lastname: Casale
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Martino
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Salvinelli
authors.forename: Marcella
authors.initials: M
authors.lastname: Trombetta
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000818:Animals; D004210:Dissection / Q000379:methods*; D006801:Humans; D015080:Mesna / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control; D020011:Protective Agents / Q000008:administration & dosage*; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods
chemical_list: D020011:Protective Agents; D015080:Mesna