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DOI: 10.1055/a-1315-0059
Fibrin glue: Novel submucosal injection agent for endoscopic submucosal dissection
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Abstract
Background and study aims Adequate mucosal elevation by submucosal injection is crucial for patient safety and efficiency during endoscopic submucosal dissection (ESD). This study aimed to evaluate the efficacy of fibrin glue (FG) as a long-lasting submucosal injection agent and to evaluate the technical feasibility of FG injection for ESD.
Materials and methods To compare the capabilities of different agents in maintaining submucosal evaluation, we injected FG, hyaluronic acid solution, and normal saline into the porcine gastric specimen that was incised into approximately 5 × 5 cm squares. Then, we measured the height of submucosal elevations over time. Moreover, three hypothetical lesions from the resected porcine stomach underwent ESD with FG injection. Thereafter, we conducted macroscopic and histopathologic analyses.
Results FG maintained the greatest submucosal elevation among all the injection agents. Three ESD procedures were performed with en bloc resection. Both macroscopic and histopathologic findings showed a thick FG clot on the ulcers.
Conclusions The FG solution can be potentially used as an ESD submucosal injection agent in an in vitro model.
Publication History
Received: 20 June 2020
Accepted: 05 October 2020
Article published online:
18 February 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Maple JT, Abu Dayyeh BK, Chauhan SS. et al. Endoscopic submucosal dissection. Gastrointest Endosc 2015; 81: 1311-1325
- 2 Fujishiro M, Yahagi N, Kashimura K. et al. Comparison of various submucosal injection solutions for maintaining mucosal elevation during endoscopic mucosal resection. Endoscopy 2004; 36: 579-583
- 3 William D. Spotnitz. Fibrin sealant: The only approved hemostat, sealant, and adhesive-a Laboratory and Clinical Perspective. ISRN Surgery 2014; 203943
- 4 Rutgeerts P, Rauws E, Wara P. et al. Randomised trial of single and repeated fibrin glue compared with injection of polidocanol in treatment of bleeding peptic ulcer. Lancet 1997; 350: 692-696
- 5 Pescatore P, Verbeke C, Harle M. et al. Fibrin sealing in peptic ulcer bleeding: the fate of the clot. Endoscopy 1998; 30: 519-523
- 6 Becker JC, Beckbauer M, Domschke W. et al. Fibrin glue, healing of gastric mucosal injury, and expression of growth factors: results from a human in vivo study. Gastrointest Endosc 2005; 61: 560-567
- 7 Pundzius J, Jievaltas M. Experimental studies of injection agents for peptic ulcer bleeding endoscopic control. Int Surg 1998; 83: 280-282
- 8 Takao T, Takegawa Y, Shinya N. et al. Tissue shielding with polyglycolic acid sheets and fibrin glue on ulcers induced by endoscopic submucosal dissection in a porcine model. Endosc Int Open 2015; 03: E146-E151
- 9 Oda I, Nonaka S, Abe S. et al. Is there a need to shield ulcers after endoscopic submucosal dissection in the gastrointestinal tract?. Endosc Int Open 2015; 03: E152-E153
- 10 Takao T, Takegawa Y, Ono H. et al. A novel and effective delivery method for polyglycolic acid sheets to post-endoscopic submucosal dissection ulcers. Endoscopy 2017; 49: 359-364