title: Usefulness of sodium hyaluronate solution in colorectal endoscopic mucosal resection.
abstract: BACKGROUND
  In endoscopic mucosal resection (EMR), it is essential to inject submucosal fluid to prevent complications and ensure safe and complete en bloc resection of tumors. Sodium hyaluronate (SH) solution, which is effective in forming and maintaining a mucosal lift and is innocuous to mucosal tissue, is considered a useful injection solution for endoscopic submucosal dissection, a procedure associated with a high risk of perforation. This study was undertaken to assess the usefulness of this solution in EMR.
  
  
  METHODS
  Ninety-four patients with colorectal tumors of ≤20 mm in diameter were enrolled for this study and randomized to a SH solution group (0.2% two-fold diluted MucoUp) or to a normal saline group (control). Ease of EMR was primarily assessed based on ease of submucosal injection, ease of snaring and injection time.
  
  
  RESULTS
  SH solution was superior to normal saline for ease of submucosal injection (57 ± 0.7 vs 50 ± 0.7; P < 0.05), and it showed better results for ease of snaring with less variability (63 ± 0.8 vs 51 ± 1.0; P < 0.05). The mean injection time was similar between the two groups (3.0 ± 9.0 s and 3.0 ± 2.7 s, respectively). Post-procedural hemorrhage occurred in 7% patients (3/46) injected with SH solution and in 6% of patients (3/48) in the control group; there was no significant difference between the groups.
  
  
  CONCLUSIONS
  Use of two-fold diluted MucoUp facilitated colorectal EMR.
authors.affiliation: Division of Endoscopy, Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation Center for Research, Tokyo, Japan.
authors.forename: Teruhito
authors.initials: T
authors.lastname: Kishihara
authors.forename: Akiko
authors.initials: A
authors.lastname: Chino
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Uragami
authors.forename: Natsuko
authors.initials: N
authors.lastname: Yoshizawa
authors.forename: Mizuka
authors.initials: M
authors.lastname: Imai
authors.forename: Taishi
authors.initials: T
authors.lastname: Ogawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Igarashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D055675:Viscosupplements / Q000008:administration & dosage
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid