Successful outcomes of a novel endoscopic treatment for GI tumors

Endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar

Mitsuhiro Fujishiro, Naohisa Yahagi, Masanori Nakamura, Naomi Kakushima, Shinya Kodashima, Satoshi Ono, Katsuya Kobayashi, Takuhei Hashimoto, Nobutake Yamamichi, Ayako Tateishi, Yasuhito Shimizu, Masashi Oka, Keiji Ogura, Takao Kawabe, Masao Ichinose, Masao Omata

Research output: Contribution to journalArticle

206 Citations (Scopus)

Abstract

Background: Endoscopic submucosal dissection (ESD) has recently been developed for endoscopic treatment of GI tumors, which enables us to resect even large tumors en bloc. However, a considerable frequency of perforation has become another problem. The best way to prevent perforation is to create a sufficient submucosal fluid cushion (SFC). The aim of this study is to find out the feasibility of ESD by using a mixture of 1900 KDa hyaluronic acid (Suvenyl) and a 10% glycerin plus 5% fructose solution (Glyceol). Methods: Sixty-seven consecutive GI tumors in 54 patients who met indication criteria of ESD were enrolled. The mixing ratios of Suvenyl and Glyceol were 1:3 for esophageal/colorectal tumors and stomach tumors with scar, and 1:7 for stomach tumors without scar. After creation of SFCs, mucosal incision around the tumors and submucosal dissection under the tumors were made by cutting devices. The clinical outcomes were investigated. Results: Mean resected and tumor sizes were 38.6 and 25.6 mm, respectively. Perforation occurred in one colon tumor with severe fibrosis (1.5%), which was managed by endoscopic clipping without salvage surgery. No blood transfusion was performed. In one stomach and in one rectal tumor (3%), endoscopic hemostasis was necessary because of postoperative bleeding. Overall endoscopic and histologic en bloc resection rates were 94% (63/67) and 78% (52/67), respectively, and there was no recurrence after follow-up of 1 year. Conclusions: ESD when using a mixture of Suvenyl and Glyceol results in excellent outcomes, and this injection solution should be used for ESD.

Original languageEnglish
Pages (from-to)243-249
Number of pages7
JournalGastrointestinal Endoscopy
Volume63
Issue number2
DOIs
Publication statusPublished - 2006 Feb
Externally publishedYes

Fingerprint

Hyaluronic Acid
Glycerol
Molecular Weight
Neoplasms
Stomach
Therapeutics
Cicatrix
Endoscopic Hemostasis
Endoscopic Mucosal Resection
Rectal Neoplasms
Fructose
Blood Transfusion
Dissection
Colorectal Neoplasms
Colon
Fibrosis
Hemorrhage
Recurrence
Equipment and Supplies
Injections

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Successful outcomes of a novel endoscopic treatment for GI tumors : Endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar. / Fujishiro, Mitsuhiro; Yahagi, Naohisa; Nakamura, Masanori; Kakushima, Naomi; Kodashima, Shinya; Ono, Satoshi; Kobayashi, Katsuya; Hashimoto, Takuhei; Yamamichi, Nobutake; Tateishi, Ayako; Shimizu, Yasuhito; Oka, Masashi; Ogura, Keiji; Kawabe, Takao; Ichinose, Masao; Omata, Masao.

In: Gastrointestinal Endoscopy, Vol. 63, No. 2, 02.2006, p. 243-249.

Research output: Contribution to journalArticle

Fujishiro, M, Yahagi, N, Nakamura, M, Kakushima, N, Kodashima, S, Ono, S, Kobayashi, K, Hashimoto, T, Yamamichi, N, Tateishi, A, Shimizu, Y, Oka, M, Ogura, K, Kawabe, T, Ichinose, M & Omata, M 2006, 'Successful outcomes of a novel endoscopic treatment for GI tumors: Endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar', Gastrointestinal Endoscopy, vol. 63, no. 2, pp. 243-249. https://doi.org/10.1016/j.gie.2005.08.002
Fujishiro, Mitsuhiro ; Yahagi, Naohisa ; Nakamura, Masanori ; Kakushima, Naomi ; Kodashima, Shinya ; Ono, Satoshi ; Kobayashi, Katsuya ; Hashimoto, Takuhei ; Yamamichi, Nobutake ; Tateishi, Ayako ; Shimizu, Yasuhito ; Oka, Masashi ; Ogura, Keiji ; Kawabe, Takao ; Ichinose, Masao ; Omata, Masao. / Successful outcomes of a novel endoscopic treatment for GI tumors : Endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar. In: Gastrointestinal Endoscopy. 2006 ; Vol. 63, No. 2. pp. 243-249.
@article{005a7ac18fc549d3a81403b52142a47d,
title = "Successful outcomes of a novel endoscopic treatment for GI tumors: Endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar",
abstract = "Background: Endoscopic submucosal dissection (ESD) has recently been developed for endoscopic treatment of GI tumors, which enables us to resect even large tumors en bloc. However, a considerable frequency of perforation has become another problem. The best way to prevent perforation is to create a sufficient submucosal fluid cushion (SFC). The aim of this study is to find out the feasibility of ESD by using a mixture of 1900 KDa hyaluronic acid (Suvenyl) and a 10{\%} glycerin plus 5{\%} fructose solution (Glyceol). Methods: Sixty-seven consecutive GI tumors in 54 patients who met indication criteria of ESD were enrolled. The mixing ratios of Suvenyl and Glyceol were 1:3 for esophageal/colorectal tumors and stomach tumors with scar, and 1:7 for stomach tumors without scar. After creation of SFCs, mucosal incision around the tumors and submucosal dissection under the tumors were made by cutting devices. The clinical outcomes were investigated. Results: Mean resected and tumor sizes were 38.6 and 25.6 mm, respectively. Perforation occurred in one colon tumor with severe fibrosis (1.5{\%}), which was managed by endoscopic clipping without salvage surgery. No blood transfusion was performed. In one stomach and in one rectal tumor (3{\%}), endoscopic hemostasis was necessary because of postoperative bleeding. Overall endoscopic and histologic en bloc resection rates were 94{\%} (63/67) and 78{\%} (52/67), respectively, and there was no recurrence after follow-up of 1 year. Conclusions: ESD when using a mixture of Suvenyl and Glyceol results in excellent outcomes, and this injection solution should be used for ESD.",
author = "Mitsuhiro Fujishiro and Naohisa Yahagi and Masanori Nakamura and Naomi Kakushima and Shinya Kodashima and Satoshi Ono and Katsuya Kobayashi and Takuhei Hashimoto and Nobutake Yamamichi and Ayako Tateishi and Yasuhito Shimizu and Masashi Oka and Keiji Ogura and Takao Kawabe and Masao Ichinose and Masao Omata",
year = "2006",
month = "2",
doi = "10.1016/j.gie.2005.08.002",
language = "English",
volume = "63",
pages = "243--249",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Successful outcomes of a novel endoscopic treatment for GI tumors

T2 - Endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar

AU - Fujishiro, Mitsuhiro

AU - Yahagi, Naohisa

AU - Nakamura, Masanori

AU - Kakushima, Naomi

AU - Kodashima, Shinya

AU - Ono, Satoshi

AU - Kobayashi, Katsuya

AU - Hashimoto, Takuhei

AU - Yamamichi, Nobutake

AU - Tateishi, Ayako

AU - Shimizu, Yasuhito

AU - Oka, Masashi

AU - Ogura, Keiji

AU - Kawabe, Takao

AU - Ichinose, Masao

AU - Omata, Masao

PY - 2006/2

Y1 - 2006/2

N2 - Background: Endoscopic submucosal dissection (ESD) has recently been developed for endoscopic treatment of GI tumors, which enables us to resect even large tumors en bloc. However, a considerable frequency of perforation has become another problem. The best way to prevent perforation is to create a sufficient submucosal fluid cushion (SFC). The aim of this study is to find out the feasibility of ESD by using a mixture of 1900 KDa hyaluronic acid (Suvenyl) and a 10% glycerin plus 5% fructose solution (Glyceol). Methods: Sixty-seven consecutive GI tumors in 54 patients who met indication criteria of ESD were enrolled. The mixing ratios of Suvenyl and Glyceol were 1:3 for esophageal/colorectal tumors and stomach tumors with scar, and 1:7 for stomach tumors without scar. After creation of SFCs, mucosal incision around the tumors and submucosal dissection under the tumors were made by cutting devices. The clinical outcomes were investigated. Results: Mean resected and tumor sizes were 38.6 and 25.6 mm, respectively. Perforation occurred in one colon tumor with severe fibrosis (1.5%), which was managed by endoscopic clipping without salvage surgery. No blood transfusion was performed. In one stomach and in one rectal tumor (3%), endoscopic hemostasis was necessary because of postoperative bleeding. Overall endoscopic and histologic en bloc resection rates were 94% (63/67) and 78% (52/67), respectively, and there was no recurrence after follow-up of 1 year. Conclusions: ESD when using a mixture of Suvenyl and Glyceol results in excellent outcomes, and this injection solution should be used for ESD.

AB - Background: Endoscopic submucosal dissection (ESD) has recently been developed for endoscopic treatment of GI tumors, which enables us to resect even large tumors en bloc. However, a considerable frequency of perforation has become another problem. The best way to prevent perforation is to create a sufficient submucosal fluid cushion (SFC). The aim of this study is to find out the feasibility of ESD by using a mixture of 1900 KDa hyaluronic acid (Suvenyl) and a 10% glycerin plus 5% fructose solution (Glyceol). Methods: Sixty-seven consecutive GI tumors in 54 patients who met indication criteria of ESD were enrolled. The mixing ratios of Suvenyl and Glyceol were 1:3 for esophageal/colorectal tumors and stomach tumors with scar, and 1:7 for stomach tumors without scar. After creation of SFCs, mucosal incision around the tumors and submucosal dissection under the tumors were made by cutting devices. The clinical outcomes were investigated. Results: Mean resected and tumor sizes were 38.6 and 25.6 mm, respectively. Perforation occurred in one colon tumor with severe fibrosis (1.5%), which was managed by endoscopic clipping without salvage surgery. No blood transfusion was performed. In one stomach and in one rectal tumor (3%), endoscopic hemostasis was necessary because of postoperative bleeding. Overall endoscopic and histologic en bloc resection rates were 94% (63/67) and 78% (52/67), respectively, and there was no recurrence after follow-up of 1 year. Conclusions: ESD when using a mixture of Suvenyl and Glyceol results in excellent outcomes, and this injection solution should be used for ESD.

UR - http://www.scopus.com/inward/record.url?scp=30944434424&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=30944434424&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2005.08.002

DO - 10.1016/j.gie.2005.08.002

M3 - Article

VL - 63

SP - 243

EP - 249

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 2

ER -