Effectiveness of sodium alginate as a submucosal injection material for endoscopic mucosal resection in animal.
OBJECTIVE
Although various solutions are being tested for submucosal injection during endoscopic resection, ideal solution has not been established yet. We performed an animal study to evaluate the possibility of sodium alginate as an ideal submucosal injection solution for endoscopic mucosal resection (EMR).


METHODS
To compare the lesion-lifting properties of different solutions, injection was done to the submucosal layer of porcine stomach. Then the height of mucosal elevation was measured. In addition, EMR was performed after submucosal injection of sodium alginate solution in six dogs. Two were euthanized after 30 minutes of endoscopic observation while the others were euthanized after 1-4 weeks. Retrieved stomachs were examined microscopically.


RESULTS
Sodium alginate and sodium hyaluronate solutions maintained longer elevation of the submucosal layer than other solutions. There was no significant difference in the height between two solutions. A clear separation of the mucosal layer from the proper muscle layer was achieved by injecting sodium alginate solution. Histological examination of EMR-induced artificial ulcers revealed no apparent tissue damage and showed normal healing process.


CONCLUSIONS
Sodium alginate solution creates a sufficient submucosal fluid cushion without apparent tissue damage. It can be considered as an effective submucosal injection material.
Eun
Soo Hoon
SH
Institute for Digestive Research, SoonChunHyang University College of Medicine, Seoul, Korea.
Cho
Joo Young
JY
Jung
In Seop
IS
Ko
Bong Min
BM
Hong
Soo Jin
SJ
Ryu
Chang Beom
CB
Kim
Jin Oh
JO
Jin
So Young
SY
Lee
Joon Seong
JS
Lee
Moon Sung
MS
Shim
Chan Sup
CS
Kim
Boo Sung
BS