title: IMPROVED EXPERIMENTAL MODEL TO EVALUATE SUBMUCOSAL INJECTION SOLUTIONS FOR ENDOSCOPIC SUBMUCOSAL DISSECTION.
abstract: BACKGROUND
  Endoscopic submucosal dissection carries an increased risk of bleeding and perforation. The creation of a long lasting submucosal cushion is essential for the safe and complete removal of the lesion. There is not a suitable experimental model for evaluation of the durability of the cushioning effect of different solutions.
  
  
  OBJECTIVE
  To describe an improved experimental model to evaluate submucosal injection solutions.
  
  
  METHODS
  A total of four domestic pigs were employed to evaluate two different submucosal fluid solutions in the gastric submucosa. After midline laparotomy, the anterior gastric wall was incised from the gastric body to the antrum and its mucosal surface was exposed by flipping inside out the incised gastric wall. Two different solutions (10% mannitol and normal saline) were injected in the submucosa of the anterior wall of the distal gastric body. All submucosal cushions were injected until they reach the same size, standardized as 1.0 cm in height and 2.0 cm in diameter. A caliper and a ruler were employed to guarantee accuracy of the measurements.
  
  
  RESULTS
  All four animal experiments were completed. All submucosal cushions had the exact same size measured with caliper and a ruler. By using the mannitol solution, the mean duration of the submucosal cushion was longer than the saline solution: 20 and 22 min (mean, 21 min) vs 5 and 6 min (mean, 5.5 min)
  
  
  CONCLUSIONS
  This experimental model is simple and evaluate the duration, size, and effect of the submucosal cushion, making it more reliable than other models that employ resected porcine stomachs or endoscopic images in live porcine models.
authors.affiliation: Medical School, São Paulo University.
authors.forename: Kendi
authors.initials: K
authors.lastname: Yamazaki
authors.affiliation: Medical School, São Paulo University.
authors.forename: Fauze
authors.initials: F
authors.lastname: Maluf-Filho
authors.affiliation: Medical School, São Paulo University.
authors.forename: Vitor Alves Pessoa
authors.initials: VA
authors.lastname: da Costa
authors.affiliation: Medical School, São Paulo University.
authors.forename: Fernanda Cristina Simões
authors.initials: FC
authors.lastname: Pessorrusso
authors.affiliation: Medical School, São Paulo University.
authors.forename: Fabio Yuji
authors.initials: FY
authors.lastname: Hondo
authors.affiliation: Medical School, São Paulo University.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
authors.affiliation: Medical School, São Paulo University, São Paulo, SP, Brazil.
authors.forename: Luis Francisco Poli
authors.initials: LF
authors.lastname: de Figueiredo
mesh_terms: D000818:Animals; D004210:Dissection / Q000379:methods*; D005069:Evaluation Studies as Topic; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy; D007267:Injections; D023421:Models, Animal; D012996:Solutions / Q000008:administration & dosage*; D013552:Swine
chemical_list: D012996:Solutions