Efficacy and safety of a thermosensitive hydrogel for endoscopic submucosal dissection: An in vivo swine study

Jeon, Han Jo and Choi, Hyuk Soon and Bang, Eun Ju and Lee, Kang Won and Kim, Sang Hyun and Lee, Jae Min and Kim, Eun Sun and Keum, Bora and Tae Jeen, Yoon and Lee, Hong Sik and Chun, Hoon Jai and Jeong, Seung and Kim, Jong Hyuk and Xu, Bing (2021) Efficacy and safety of a thermosensitive hydrogel for endoscopic submucosal dissection: An in vivo swine study. PLOS ONE, 16 (12). e0260458. ISSN 1932-6203

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Abstract

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/β-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 (mm2/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.

Item Type: Article
Subjects: Scholar Eprints > Biological Science
Depositing User: Managing Editor
Date Deposited: 30 Jan 2023 05:29
Last Modified: 15 Oct 2024 11:41
URI: http://repository.stmscientificarchives.com/id/eprint/864

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