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World J Gastroenterol. May 28, 2013; 19(20): 3069-3076
Published online May 28, 2013. doi: 10.3748/wjg.v19.i20.3069
Published online May 28, 2013. doi: 10.3748/wjg.v19.i20.3069
Efficacy and safety of 0.4 percent sodium hyaluronate for endoscopic submucosal dissection of gastric neoplasms
Young Dae Kim, Jun Lee, Ju Yeon Cho, Seok Won Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical School, Chosun University, Gwangju 501-717, South Korea
Seong Hwan Kim, Young Kwan Cho, Department of Internal Medicine, Eulji Hospital, Eulji University, Seoul 139-872, South Korea
Jin Seok Jang, Ji Sun Han, Department of Internal Medicine, Dong A University College of Medicine, Busan 602-715, South Korea
Joo Young Cho, Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul 140-743, South Korea
Author contributions: Kim YD, Kim SH, Jang JS and Cho JY supervised and performed the experiments; Lee J, Cho JY, Kim SW, Cho YK and Han JS performed the majority of the experiments; Kim YD drafted and wrote the manuscript.
Supported by BMI Korea, Co., Ltd
Correspondence to: Joo Young Cho, MD, PhD, Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, 22, Daesagwn-gil, Yongsangu, Seoul 140-743, South Korea. cjy6695@dreamwiz.com
Telephone: +82-2-7099202 Fax: +82-2-7099202
Received: December 29, 2012
Revised: March 19, 2013
Accepted: April 13, 2013
Published online: May 28, 2013
Revised: March 19, 2013
Accepted: April 13, 2013
Published online: May 28, 2013
Core Tip
Core tip: Saline-assisted endoscopic mucosal resection is an established method for excision of nonpolypoid early neoplastic lesions of the gastrointestinal tract. However, it is sometimes difficult to maintain a desired level of tissue elevation after injection of saline, especially when using a one-channeled endoscope. Adequate elevation of the mucosa and sufficient elevation time is achieved more effectively when a material more viscous than normal saline (NS) is used. The 0.4% sodium hyaluronate solution (SH) used in this study provides a more effective and prolonged cushion effect for large lesions without serious adverse events compared to NS. Therefore, endoscopic submucosal dissection (ESD) with SH is more useful than ESD with NS.