Efficacy and safety of a thermosensitive hydrogel for endoscopic submucosal dissection: An in vivo swine study
- Jeon, Han Jo; Choi, Hyuk Soon; Bang, Eun Ju; Lee, Kang Won; Kim, Sang Hyun; Lee, Jae Min; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon Jai; Jeong, Seung; Kim, Jong Hyuk
- Issue Date
- Public Library of Science
- PLoS ONE, v.16, no.12
- Journal Title
- PLoS ONE
- Injectable thermo-sensitive chitosan hydrogels have recently been developed for the use of submucosal fluids in endoscopic submucosal dissections (ESD). This study aimed to investigate the efficacy and safety of chitosan hydrogels during ESD. Submucosal fluids were administered as follows: 0.9% normal saline (NS), 0.4% hyaluronic acid (HA) and chitosan/beta-glycerophosphate (CS/GP) hydrogel. Each solution was administered twice into the stomach and colon of a pig, with a total of 72 ESD procedures performed on 12 pigs. The injected volume and procedure-related parameters were recorded and analyzed. ESDs that created ulcers after 7 days were histologically compared. All ESD specimens were resected en bloc. The total injected volumes during ESD of the stomach (NS, 16.09 +/- 3.27 vs. HA, 11.17 +/- 2.32 vs. CS/GP, 9.44 +/- 2.33; p<0.001) and colon (NS, 9.17 +/- 1.80 vs. HA, 6.67 +/- 1.50 vs. CS/GP, 6.75 +/- 1.57; p = 0.001) were significantly different. Hydrogel showed significant differences from normal saline in terms of fluid power (mm(2)/vol; NS, 35.70 +/- 9.00 vs. CS/GP 57.48 +/- 20.77; p = 0.001) and consumption rate (vol/min; NS, 2.59 +/- 0.86 vs. CS/GP, 1.62 +/- 0.65; p = 0.013) in the stomach. Histological examination revealed preserved muscularis propria, although the chitosan hydrogel resulted in a partial inflammatory response, with a hypertrophied submucosal layer. Chitosan hydrogel was found to be superior to normal saline, with an efficacy similar to that of hyaluronic acid. Nonetheless, long-term histological changes should be evaluated before clinical implementation.
- Files in This Item
- There are no files associated with this item.
- Appears in
- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.