Efficacy of Sodium Carboxymethylcellulose Compared to Sodium Hyaluronate as Submucosal Injectant for Gastric Endoscopic Submucosal Dissection: A Randomized Controlled Trial

透明质酸钠 内镜黏膜下剥离术 医学 随机对照试验 胃肠病学 粘膜切除术 不利影响 内科学 切除术 外科
作者
Jun Nakamura,Takuto Hikichi,Ko Watanabe,Minami Hashimoto,Tsunetaka Kato,Tadayuki Takagi,Rei Suzuki,Mitsuru Sugimoto,Mika Takasumi,Yuki Sato,Hiroki Irie,Ryoichiro Kobashi,Hitomi Kikuchi,Yuichi Waragai,Masao Kobayakawa,Masahiro Yamasaki,Hiromasa Ohira
出处
期刊:Digestion [Karger Publishers]
卷期号:102 (5): 753-759 被引量:3
标识
DOI:10.1159/000513148
摘要

<b><i>Introduction:</i></b> Sodium hyaluronate (SH) is a useful submucosal injectant for gastric endoscopic submucosal dissection (ESD). On the other hand, sodium carboxymethylcellulose (SCMC), which has high viscosity, has also been applied clinically. We evaluated the efficacy of SCMC compared to that of SH in gastric ESD. <b><i>Methods:</i></b> A prospective randomized controlled trial was conducted to assess the efficacy of 1.0% SCMC as the injectant (SCMC group) compared to 0.4% SH (SH group) for ESD of gastric neoplasms. The primary end point was the procedure time of ESD. Secondary end points were treatment outcomes such as en bloc and R0 resection rates, number of hemostases, amount of injectant, ease of treatment (visual analog scale, 1–10 points), adverse events, and rate of ulcer healing 8 weeks after ESD. <b><i>Results:</i></b> A total of 60 patients were enrolled between October 2014 and October 2018, and 30 patients were allocated in each group. The procedure time (mean ± SD, minutes) was not significantly different between the SCMC (74.7 ± 54.5) and SH groups (67.1 ± 41.4) (<i>p</i> = 0.547). Furthermore, there were no differences between the 2 groups in terms of en bloc and R0 resection rates, number of hemostases, amount of injectant, ease of treatment, and rate of ulcer healing. No serious adverse events were observed in either group. <b><i>Conclusion:</i></b> SCMC was comparable to SH in terms of procedure time, treatment outcome, and ease and safety of treatment in gastric ESD. Further studies are needed to demonstrate the differences between the 2 injectants.

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