Experimental study on the effect of submucosal injection of sodium alginate on mucosal eminence
Objective In this study,the height and duration of mucosal bulge were used as indicators,and normal saline(NS)and 0.4％sodium hyaluronate(SH)were used as negative and positive controls,respectively,to evaluate the effect of injecting sodium alginate(SA)solution with different molecular weights and concentrations,and to explore the feasibility and effectiveness of SA for endoscopic submucosal dissection(ESD).Methods ① The same dose of SA solution with different molecular weight and concentration was injected into the mucosa of fresh isolated pig stomach.The height of mucosal eminence and its change with time were observed and measured.②In order to simulate ESD operation,SA solution with a molecular weight of 80 KDa and a concentration of 0.3％was injected into the stomach of live pigs to observe and compare the process of complete peeling of mucous membranes of the same size,and to perform histopathological examination.Results In vitro experiment,there was no significant difference between the injection of low-concentration SA solution with a molecular weight of 80 kDa and that of the negative control group.However,when the concentration was ≥0.3％,the height of the bulge gradually decreased with the extension of time during the observation period,and the height of the bulge at 30 min was 0.783±0.029 cm,which was lower than that at 0 min,1.083±0.104 cm.When the molecular weight of SA is 100 kDa,150 KDa,and 250 KDa,and the concentration is 0.1％-0.5％,the optimal height and retention time of the uplift are not significantly dependent on the concentration and molecular weight,and the optimal height of the uplift is 0.7-0.8 cm,and the retention time is more than 30 min.All were significantly better than NS(P＜0.001),but had no significant difference compared with positive control(P＞0.05).In vivo experiments,both SA solution and SH solution with molecular weight of 80 kDa and concentration of 0.3％could significantly uplift mucous membranes and separate tissues,and both maintained good mucosal elevation and duration.During the process of mucosal dissection,the mucosa was completely removed by ESD in both cases,and no complications such as perforation and bleeding occurred.According to histopathological examination,sodium alginate solution had no damage to the mucosal layer.Conclusion When the SA solution reaches a certain molecular weight and concentration,the submucosal injection of SA solution can better maintain the mucosal elevation,and there is no significant difference compared with the SH control group,which is expected to assist the stripping and excision of mucosal tissue during ESD surgery.Therefore,sodium alginate is a potential submucosal injection in clinic.
Endoscopic diagnosis and treatment of early cancer of digestive tractEndoscopic submucosal dissectionEndoscopic mucosal resectionSubmucosal injectionsodium alginate
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维普
