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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(03): E319-E323
DOI: 10.1055/a-1315-0059
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Fibrin glue: Novel submucosal injection agent for endoscopic submucosal dissection

Madoka Takao
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
,
Yoshitaka Takegawa
2   Research & Development Division, Medical Affairs Section, KM Biologics Co., Ltd., Kumamoto, Japan
,
Toshitatsu Takao
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
,
Hiroya Sakaguchi
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
,
Yoshiko Nakano
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
,
Shinwa Tanaka
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
,
Yoshinori Morita
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
,
Takashi Toyonaga
3   Department of Endoscopy, Kobe University Hospital, Kobe, Hyogo, Japan
,
Eiji Umegaki
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
,
Hiromu Kutsumi
4   Center for Clinical Research and Advanced Medicine, Shiga University of Medical Science, Shiga, Otsu, Japan
,
Yuzo Kodama
1   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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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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