title: Endoscopic mucosal resection with an over-the-counter hyaluronate preparation.
abstract: BACKGROUND
  Hyaluronic acid (HA) provides a long-lasting and distinct mucosal elevation for EMR, but expense and inconvenience have limited its adoption.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of an over-the-counter 0.15% HA preparation for EMR.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Veterans Administration Hospital and university hospital.
  
  
  METHODS
  30 patients with a total of 32 colonic lesions and 1 duodenal lesion.
  
  
  METHODS
  EMR by using HA.
  
  
  METHODS
  En bloc resection rate and complications.
  
  
  RESULTS
  EMR was successful in all cases. En bloc resection was achieved in 26 of the 28 lesions up to 25 mm in diameter. Two lesions, both with fibrosis from prior attempted resection, had trace residual tissue necessitating cauterization with argon plasma. Five lesions measuring 30 mm to 60 mm all required piecemeal resection. There was one complication, a postpolypectomy bleed.
  
  
  CONCLUSIONS
  Small number of patients and retrospective design.
  
  
  CONCLUSIONS
  EMR may be performed safely and effectively by using an inexpensive, over-the-counter 0.15% HA preparation. Further studies are needed to verify the results of this study and to compare the safety and efficacy of this HA preparation with saline solution.
authors.affiliation: Department of Gastroenterology, Veterans Administration Palo Alto Health Care System, Palo Alto, California, USA. shai_friedland@yahoo.com
authors.forename: Shai
authors.initials: S
authors.lastname: Friedland
authors.forename: Shivangi
authors.initials: S
authors.lastname: Kothari
authors.forename: Ann
authors.initials: A
authors.lastname: Chen
authors.forename: Walter
authors.initials: W
authors.lastname: Park
authors.forename: Subhas
authors.initials: S
authors.lastname: Banerjee
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods; D004379:Duodenal Neoplasms / Q000473:pathology / Q000601:surgery*; D004384:Duodenoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D004366:Nonprescription Drugs; D006820:Hyaluronic Acid